Basic Information
| Provider Information | |||||||||
| NPI: | 1306282439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | NIRAV | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9600 GROSS POINT ROAD | ||||||||
| Address2: | DEPARTMENT OF ANESTHESIA | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479336974 | ||||||||
| FaxNumber: | 8479333829 | ||||||||
| Practice Location | |||||||||
| Address1: | 9600 GROSS POINT ROAD | ||||||||
| Address2: | DEPARTMENT OF ANESTHESIA | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479336974 | ||||||||
| FaxNumber: | 8479333829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2013 | ||||||||
| LastUpdateDate: | 10/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 036144944 | IL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 036144944 | IL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.