Shah, Ravi M.

Shah, Ravi M. is an individual health care provider with primary practice located at 7543 183Rd St , Tinley Park IL 60477-6208. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Shah, Ravi M. can be contacted via phone (708) 263-2000.

Contact Information

Primary practice address
7543 183Rd St Tinley Park IL 60477-6208
Phone: (708) 263-2000
Fax: (708) 263-2023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 125.070237 Illinois
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036.149951 Illinois

Profile Details

NPI number 1326579103
LBN Legal business name Shah, Ravi M.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2017
Last updated May 6th, 2024 - about 4 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326579103 NPPES
Illinois MEDICAID 1326579103

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