Y.M.Shahmdsc

Primary specialty

SpecialistTaxonomy code 174400000X

License

036067943 Issued in IL

Legal business name

Y.M.SHAHMDSC

Doing business as

primary care joliet

Practice address

2025 S Chicago St
Joliet, IL 60436-3172

Phone

(815) 726-2200

Fax

(815) 727-4573

NPI assigned

Mar 5, 2009

Organization subpart

No

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

Authorized official

Name

Yatin M Shah, M.D.

Title

Physician/Owner

Phone

(815) 726-2200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• primary care joliet Doing business as

Locations

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1487894390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 S CHICAGO ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604363172",
            "telephone_number": "815-726-2200",
            "fax_number": "815-727-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S CHICAGO ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604363172",
            "telephone_number": "815-726-2200",
            "fax_number": "815-727-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "Y.M.SHAHMDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "YATIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "815-726-2200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036067943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "989190",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "primary care joliet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph P. Wubben, CRNA
• Russell E Wudel, PA-C
• Wunderlich MD SC
• Andrew Warren Wunderlich, M.D.
• Ashley Wynne, RBT
• Oscar Guillermo Yanes, M.A.
• Ahyun Yang, LSW
• Nelia Yarbrough
• Yatin M Shah MD SC
• Yatin M Shah MD SC

• Specialist in Joliet, IL
• Providers in Joliet, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.