Shital B Shah, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036058187 Issued in IL

Practice address

1515 Lake St
Alexian Brother St Alexius Medical Center
Hanover Park, IL 60133

Phone

(847) 472-1500

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Olopi C Shah Other name

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

Specialty

Family PracticeAlso: Internal Medicine

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shital.shah@loretto.medalliesdirect.net

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment NPD
• Bonaventure Medical Foundation, LLC

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  NPD (past)
• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)
• Presence Healthcare Services

  • Multi-Specialty Clinic/Center
  • Elk Grove Village, IL
  • NPI 1932216819

  Family Medicine

  NPD (past)
• Resurrection Services

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1710907456
  NPD (past)
• Rush Oak Park Hospital, Inc.

  • Internal Medicine Physician
  • Oak Park, IL
  • NPI 1417914839
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1770517070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W ESTES AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121032",
            "telephone_number": "773-383-0006",
            "fax_number": "847-983-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 LAKE ST",
            "address_2": "ALEXIAN BROTHER ST ALEXIUS MEDICAL CENTER",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "60133",
            "telephone_number": "847-472-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHITAL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036058187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "1619414",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058187",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLOPI",
            "last_name": "SHAH",
            "middle_name": "C",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Esther Sellers
• Ami K Shah, DDS
• Avani Shah, D.C
• Avani Shah, PHARM D
• Kavita Shah, D.D.S
• Vinod Shah, RPH
• Shant PLLC
• Nishu Sharma, D.D.S
• Phyllis K. Siebert, LCPC, CADC
• Smart Choice Management LLC

• Family Medicine Physician in Hanover Park, IL
• Providers in Hanover Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.