Provider Demographics
NPI:1730297995
Name:SHAH NAWAZ, MD INC
Entity Type:Organization
Organization Name:SHAH NAWAZ, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAWAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-686-2222
Mailing Address - Street 1:3800 N WILKE RD
Mailing Address - Street 2:SUITE # 160
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1278
Mailing Address - Country:US
Mailing Address - Phone:847-686-2222
Mailing Address - Fax:847-342-0378
Practice Address - Street 1:3800 N WILKE RD
Practice Address - Street 2:SUITE 160
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1278
Practice Address - Country:US
Practice Address - Phone:847-686-2222
Practice Address - Fax:847-342-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH55857Medicare UPIN