Provider Demographics
NPI:1659576536
Name:SHAH, TEJAL UDAY (MD)
Entity type:Individual
Prefix:DR
First Name:TEJAL
Middle Name:UDAY
Last Name:SHAH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10370 HALIGUS RD STE 117
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9582
Mailing Address - Country:US
Mailing Address - Phone:815-344-3900
Mailing Address - Fax:847-802-7207
Practice Address - Street 1:10370 HALIGUS RD STE 117
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9582
Practice Address - Country:US
Practice Address - Phone:815-344-3900
Practice Address - Fax:847-802-7207
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53296-20207RE0101X
IL036147983207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism