NPIMap

Organization Active NPI

Shifa Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
National Provider Identifier
1770858425
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SHIFA DIALYSIS LLC
Practice address
1540 W. Chicago Ave
Chicago, IL 60642
Phone
(773) 423-6400
Fax
(773) 423-8440
NPI assigned
Mar 14, 2012
Last updated
Mar 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Authorized official

Name
Dr. Farheen M Shah-Khan, M.D.NPI 1164644480
Title
President
Phone
(773) 423-6400

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
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1540 W. Chicago Ave
Chicago, IL 60642

Mailing address

PO Box 597315
Chicago, IL 60659-7315
Phone (773) 423-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130204000375 IL Part A Provider - End-Stage Renal Disease Facility (ESRD) 2466606215 Practice locations: Chicago, IL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Shifa DialysisCCN 142816
Ownership
Profit
Certified
Jun 12, 2017
Medicare certification status
ActiveFrom the Provider of Services file

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1770858425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597315",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606597315",
            "telephone_number": "773-423-6400",
            "fax_number": "773-423-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 W. CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60642",
            "telephone_number": "773-423-6400",
            "fax_number": "773-423-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "SHAH-KHAN",
        "authorized_official_first_name": "FARHEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-423-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "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 Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.