Kumudchandra S Shah, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036048096 Issued in IL

Practice address

17680 S Kedzie Ave
Suite 201
Hazel Crest, IL 60429-2043

Phone

(708) 799-5420

Fax

(708) 799-4093

NPI assigned

Nov 30, 2006

Sex

Male

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

• Kumud S Shah Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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 Community Medical Center Harvey, S.C.

  • Adult Medicine Physician
  • Harvey, IL
  • NPI 1578846465
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1891862959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17680 S KEDZIE AVE",
            "address_2": "SUITE 201",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292043",
            "telephone_number": "708-799-5420",
            "fax_number": "708-799-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17680 S KEDZIE AVE",
            "address_2": "SUITE 201",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292043",
            "telephone_number": "708-799-5420",
            "fax_number": "708-799-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KUMUDCHANDRA",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036048096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048096",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21605584",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KUMUD",
            "last_name": "SHAH",
            "middle_name": "S",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Olivia Schultz
• Eliezer L. Schwartz, PH.D.
• Marilyn C Scott, PSY.D
• Serenity Internal Medicine & Wellness Center
• SFZ Corporation
• Neilesh Shah, MD
• Vipuj A Shah, MD
• Bansi D. Sharma, M.D.
• Bhanoo Sharma, M.D.
• Primla K. Sharma, M.D.

• Obstetrics & Gynecology Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.