Individual provider Active NPI

Tejal Uday Shah, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Huntley, IL
National Provider Identifier
1659576536
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036147983 Issued in IL
Practice address
10370 Haligus Rd Ste 117
Huntley, IL 60142-9582
Phone
(815) 344-3900
Fax
(847) 802-7207
NPI assigned
Jun 19, 2007
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 53296-20 WI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036147983 IL Primary

Addresses

Primary practice location

10370 Haligus Rd Ste 117
Huntley, IL 60142-9582

Mailing address

10370 Haligus Rd Ste 117
Huntley, IL 60142-9582
Phone (815) 344-3900

Other practice location 1

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-4015

Other practice location 2

360 Station Dr Ste 300
Crystal Lake, IL 60014-8003
Phone (815) 344-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250416003997 IL Practitioner - Internal MedicinePractitioner - Endocrinology 5193951788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53296-20WIMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1659576536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10370 HALIGUS RD STE 117",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429582",
            "telephone_number": "815-344-3900",
            "fax_number": "847-802-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10370 HALIGUS RD STE 117",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429582",
            "telephone_number": "815-344-3900",
            "fax_number": "847-802-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 S Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Cudahy",
            "state": "WI",
            "postal_code": "531103171",
            "country_code": "US",
            "telephone_number": "414-489-4015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600148003",
            "country_code": "US",
            "telephone_number": "815-344-3900",
            "fax_number": "815-356-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "TEJAL",
        "middle_name": "UDAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "53296-20",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036147983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntley, IL

Sources for this page

Verify at the official NPI Registry.