Shah, Pradip
Shah, Pradip is an individual health care provider with primary practice located at 200 E Fairman Ave , Watseka IL 60970-1644. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Shah, Pradip can be contacted via phone (630) 321-8300.Contact Information
Primary practice address
200 E Fairman Ave
Watseka IL 60970-1644
Phone: (630) 321-8300
Fax: (630) 321-8750
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036-055221 | Illinois |
Profile Details
| NPI number | 1891789244 |
|---|---|
| LBN Legal business name | Shah, Pradip |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Oct 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891789244 | NPPES |
| Illinois | MEDICAID | 036-055221 |
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