Provider Demographics
NPI:1184927121
Name:SINGH, SHILPA RAJ (MD)
Entity type:Individual
Prefix:
First Name:SHILPA
Middle Name:RAJ
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-3596
Mailing Address - Country:US
Mailing Address - Phone:773-484-4783
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NEBRASKA MEDICAL CTR
Practice Address - Street 2:600 SOUTH 42ND STREET
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-9350
Practice Address - Country:US
Practice Address - Phone:205-919-8946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036131249208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty