Provider Demographics
NPI:1659151140
Name:SHAH-NI-4 INC.
Entity Type:Organization
Organization Name:SHAH-NI-4 INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:G.MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-488-4575
Mailing Address - Street 1:9514 OZANAM AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1059
Mailing Address - Country:US
Mailing Address - Phone:414-488-4575
Mailing Address - Fax:224-251-8319
Practice Address - Street 1:9514 OZANAM AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-1059
Practice Address - Country:US
Practice Address - Phone:414-488-4575
Practice Address - Fax:224-251-8319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CARE AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care