Pankaj S Shah, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

10035 Lincoln TRL
Fairview Heights, IL 62208-1847

Phone

(618) 397-7700

Fax

(618) 397-7735

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1629024815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10035 LINCOLN TRL",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081847",
            "telephone_number": "618-397-7700",
            "fax_number": "618-397-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10035 LINCOLN TRL",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081847",
            "telephone_number": "618-397-7700",
            "fax_number": "618-397-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PANKAJ",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Samson, MA. QMHP
• Allison Schaal, DPT
• Jeffrey Michael Schenck, DO
• Octavia Scott
• Kirsten Joy Settle, RN
• Shabbir A Shaikh, MD
• Jerrion Devonta Shell
• Amber Shively
• Kelli Silhavy, LCSW
• Haley Christine Simpson, LCSW

• Specialist in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.