Shah, Sudha P
Shah, Sudha P is an individual health care provider with primary practice located at 6861 Villagreen Vw , Rockford IL 61107-5639. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Shah, Sudha P can be contacted via phone (815) 637-6200.Contact Information
Primary practice address
6861 Villagreen Vw
Rockford IL 61107-5639
Phone: (815) 637-6200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 036-069064 | Illinois |
Profile Details
| NPI number | 1497753511 |
|---|---|
| LBN Legal business name | Shah, Sudha P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Jul 1st, 2015 - about 9 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 | 1497753511 | NPPES |
| Illinois | MEDICAID | 036069064 | |
| Illinois | Other | 31792700 |
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