A. N. Shah MD SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036058180 Issued in IL

Legal business name

A. N. SHAH MD SC

Practice address

2315 E 93Rd St Ste 340
Chicago, IL 60617-3948

Phone

(773) 468-9000

Fax

(847) 587-6113

NPI assigned

Aug 3, 2006

Last updated

Nov 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashvin N Shah, MDNPI 1477561744

Title

Owner

Phone

(773) 468-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Ashvin N Shah, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1477561744
  Authorized official Same address or phone

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1811905185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 SCOTT CRES",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221728",
            "telephone_number": "773-468-9000",
            "fax_number": "847-587-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E 93RD ST STE 340",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173948",
            "telephone_number": "773-468-9000",
            "fax_number": "847-587-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A. N. SHAH MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ASHVIN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-468-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036058180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058180",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Chicago, IL
• Providers in Chicago, 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 Nov 17, 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.