Active NPI
Purvi Gor Shah, NP
- Nurse Practitioner
- West Dundee, IL
National Provider Identifier
1669279196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209.031802
- Practice address
- 2786 Connolly LN
West Dundee, IL 60118-1754 - Phone
- (713) 820-8576
- NPI assigned
- Mar 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209.031802 | IL | Primary |
Addresses
Primary practice location
2786 Connolly LN
West Dundee, IL 60118-1754
Mailing address
2786 Connolly LN
West Dundee, IL 60118-1754
Phone (713) 820-8576
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.031802 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1669279196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2786 CONNOLLY LN",
"city": "WEST DUNDEE",
"state": "IL",
"postal_code": "601181754",
"telephone_number": "713-820-8576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2786 CONNOLLY LN",
"city": "WEST DUNDEE",
"state": "IL",
"postal_code": "601181754",
"telephone_number": "713-820-8576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "PURVI",
"middle_name": "GOR",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-03",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209.031802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Dundee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.