Provider Demographics
NPI:1710122742
Name:JAGDISH & SHOBHA SHAH MD SC
Entity Type:Organization
Organization Name:JAGDISH & SHOBHA SHAH MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGDISH
Authorized Official - Middle Name:RATILAL
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-733-2555
Mailing Address - Street 1:1301 S ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1300
Mailing Address - Country:US
Mailing Address - Phone:312-733-2555
Mailing Address - Fax:312-733-2555
Practice Address - Street 1:1301 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1300
Practice Address - Country:US
Practice Address - Phone:312-733-2555
Practice Address - Fax:312-733-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty