Mirab Mickey Shah, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013727 Issued in IL

Practice address

16517 106TH CT
Orland Park, IL 60467-4545

Phone

(708) 966-4386

NPI assigned

Apr 10, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Goodlife Physical TherapyGroup PAC ID 6608924865, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Goodlife Physical Therapy

  • Physical Therapist
  • Orland Park, IL
  • NPI 1053557264
  Medicare reassignment Care Compare group NPD Authorized official
• O'Connor Foundation

  dba NextSteps of O'Connor Foundation

  • Rehabilitation Practitioner
  • Willow Springs, IL
  • NPI 1891978482

  Physical Therapist

  Medicare reassignment NPD
• Accelerated Rehabilitation Centers LTD

  • Physical Therapist
  • Westmont, IL
  • NPI 1205875713
  NPD (past)

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1902079981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16517 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-966-4386",
            "fax_number": "708-966-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16517 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-966-4386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9730 S Western Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052763",
            "country_code": "US",
            "telephone_number": "708-581-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14753 Founders Xing",
            "address_purpose": "LOCATION",
            "city": "Homer Glen",
            "state": "IL",
            "postal_code": "604916716",
            "country_code": "US",
            "telephone_number": "708-645-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MIRAB",
        "middle_name": "MICKEY",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "060010072",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "568080",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "568150",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL GROUP",
            "identifier": "1619908",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "567700",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Dawn Sexton
• Dalton Lee Sexton, PHYSICIAN ASSISTANT
• Nadeen Shaban, DMD
• Shafiq Ahmed, MD, SC
• Miraj G Shah-Khan, M.D.
• Puja Shah
• Ibrahim Hassan Shalabi, LPC
• Janine-Sara Shalash, CMHC INTERN
• Nada Shalash
• Shalom Home Health LTD (Shalom Manor Care, Inc)

• Physical Therapist in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.