Individual provider Active NPI

Jai Devendra Shah, M.D., M.B.A., M.P.H.

  • Vascular & Interventional Radiology Physician
  • Libertyville, IL
National Provider Identifier
1740439009
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036.121053 Issued in IL
Practice address
801 S Milwaukee Ave
Advocate Condell Medical Center - Radiology Department
Libertyville, IL 60048-3204
Phone
(847) 990-5380
Fax
(847) 749-0696
NPI assigned
Sep 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 036.121053 IL Primary

Addresses

Primary practice location

801 S Milwaukee Ave
Advocate Condell Medical Center - Radiology Department
Libertyville, IL 60048-3204

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network
Direct Messaging Address jshah236810@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20120201000813 IL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5597922641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Imaging Consultants LLCGroup PAC ID 2567784408, 163 clinicians

Practice addresses (Care Compare)

1435 N Hunt Club Rd
Gurnee, IL 60031-2656
Phone (847) 599-7365

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-2210

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

695 Park Ave
Lake Villa, IL 60046-6531
Phone (224) 541-9100

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 990-5380

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.121053ILMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Dec 1, 2025 Accepting new patients
Integrated Imaging Consultants LLC Diagnostic Radiology CurrentSince Nov 1, 2014 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 1, 2025 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

209 Peterson Rd
Libertyville, IL 60048

900 Garfield Ave
Libertyville, IL 60048
Phone (847) 362-2900

1420 Renaissance Dr
Ste 307
Park Ridge, IL 60068
Phone (847) 803-1000

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1740439009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVE",
            "address_2": "ADVOCATE CONDELL MEDICAL CENTER - RADIOLOGY DEPARTMENT",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483204",
            "telephone_number": "847-990-5380",
            "fax_number": "847-749-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAI",
        "middle_name": "DEVENDRA",
        "credential": "M.D., M.B.A., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036.121053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshah236810@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "801 S Milwaukee Ave",
            "address_2": "Advocate Condell Medical Center - Radiology Department",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "801 S Milwaukee Ave",
            "address_2": "Advocate Condell Medical Center - Radiology Department",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.