Provider Demographics
NPI:1467865295
Name:SHAH, USHMA (DO)
Entity type:Individual
Prefix:
First Name:USHMA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 N MILWAUKEE AVE
Mailing Address - Street 2:STE 231A
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3247
Mailing Address - Country:US
Mailing Address - Phone:773-989-3808
Mailing Address - Fax:
Practice Address - Street 1:7900 N MILWAUKEE AVE STE 231A
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3247
Practice Address - Country:US
Practice Address - Phone:847-663-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143281207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease