| Shefali Shah Md Sc | |
|
2526 N Lincoln Ave Chicago IL 60614-2353 | |
| (773) 929-7410 | |
| Not Available |
| Full Name | Shefali Shah Md Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 2526 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Shefali Shah (PRESIDENT) |
| Authorized Official Contact | 7733489029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shefali Shah Md Sc 885 W Lill Ave Unit 4 Chicago IL 60614-6447 Ph: (773) 348-9029 | Shefali Shah Md Sc 2526 N Lincoln Ave Chicago IL 60614-2353 Ph: (773) 929-7410 |
| NPI Number | 1518377324 |
|---|---|
| Provider Enumeration Date | 05/01/2014 |
| Last Update Date | 05/01/2014 |
| Medicare PECOS PAC ID | 9234354853 |
|---|---|
| Medicare Enrollment ID | O20140715001169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518377324 | NPI | - | NPPES |
| 036111947 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036111947 (Illinois) | Primary |
| Provider Name | Shefali K Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609815414 PECOS PAC ID: 5991725798 Enrollment ID: I20051122000680 |
| Provider Name | Indira K Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881600187 PECOS PAC ID: 5193889293 Enrollment ID: I20090205000041 |
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