Organization Active NPI

Jagdish & Shobha Shah MD SC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1710122742
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JAGDISH & SHOBHA SHAH MD SC
Practice address
1301 S Ashland Ave
Chicago, IL 60608-1300
Phone
(312) 733-2555
Fax
(312) 733-2555
NPI assigned
Dec 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Dr. Jagdish Ratilal ShahNPI 1497843460
Title
M.D.
Phone
(312) 733-2555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1301 S Ashland Ave
Chicago, IL 60608-1300

Mailing address

1301 S Ashland Ave
Chicago, IL 60608-1300
Phone (312) 733-2555

National Provider Directory

National Provider Directory

Locations

4304 W 16th St
Chicago, IL 60623
Phone (773) 277-2187

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1710122742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081300",
            "telephone_number": "312-733-2555",
            "fax_number": "312-733-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081300",
            "telephone_number": "312-733-2555",
            "fax_number": "312-733-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAGDISH & SHOBHA SHAH MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JAGDISH",
        "authorized_official_middle_name": "RATILAL",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "312-733-2555",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.