Shah, Prayag D
Shah, Prayag D is an individual health care provider with primary practice located at 575 S Perryville Rd , Rockford IL 61108-2530. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Shah, Prayag D can be contacted via phone (815) 315-9358.Contact Information
Primary practice address
575 S Perryville Rd
Rockford IL 61108-2530
Phone: (815) 315-9358
Fax: (815) 397-4684
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046009516 | Illinois |
Profile Details
| NPI number | 1720072184 |
|---|---|
| LBN Legal business name | Shah, Prayag D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Oct 5th, 2014 - about 10 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 | 1720072184 | NPPES |
| Illinois | MEDICAID | 046009516 |
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