Pravin S Shah, M.D,

Primary specialty

SpecialistTaxonomy code 174400000X

License

036055437 Issued in IL

Practice address

1400E Golf Rd 222
Des Plaines, IL 60016-1252

Phone

(847) 391-6360

Fax

(847) 391-6360

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1467473231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400E GOLF RD 222",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161252",
            "telephone_number": "847-391-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400E GOLF RD 222",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161252",
            "telephone_number": "847-391-6360",
            "fax_number": "847-391-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRAVIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036055437",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036055437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandrakant Kantilal Shah, PH.D. LCPC
• Eisha Shah
• Komal Shah
• Krupa Mahesh Shah
• Pooja Shah, P.T.
• Rachana Shah, DC
• Iman Yasmeen Shahid
• Joel I. Shalowitz, M.D.
• Abdul M Shamsuddin, PT
• Michael James Shanahan

• Specialist in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.