Shah, Sudha V.

Shah, Sudha V. is an sole proprietor health care provider with primary practice located at 1516 W Devon Ave , Chicago IL 60660-1314. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Shah, Sudha V. can be contacted via phone (773) 465-7889.

Contact Information

Primary practice address
1516 W Devon Ave Chicago IL 60660-1314
Fax: (773) 465-7615
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 036060895 Illinois

Profile Details

NPI number 1417966789
LBN Legal business name Shah, Sudha V.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417966789 NPPES
Illinois MEDICAID 036060895

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