SUDHA V. SHAH (NPI# 1417966789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417966789 |
Entity Type | Individual |
Full Name | SUDHA V. SHAH |
Credential | M.D. |
Practice Address |
1516 W Devon Ave Chicago IL 60660-1314 |
Practice Telephone | 7734657889 |
Practice Fax Number | 7734657615 |
Mailing Telephone | 7734657889 |
Mailing Fax Number | 7734657615 |
Enumeration Date | 2006-08-05 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
036060895 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036060895 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205924974 | Sudha R Shah | Family Medicine | 3860 Kings Hwy, Brooklyn, NY 11234-2907 | 2006-10-10 |
1174628978 | Sudha B Shah | Anesthesiology | 3460 Pioneer Pkwy, West Valley City, UT 84120-2049 | 2006-09-14 |
1821010844 | Sudha Shah | General Practice | 4500 College Ave, Alton, IL 62002-5051 | 2006-07-25 |
1144257213 | Sudha Satish Shah | Anesthesiology | 65 Jimmie Leeds Road, Pomona, NJ 08240 | 2006-06-26 |
1497753511 | Sudha P Shah | Obstetrics & Gynecology | 6861 Villagreen Vw, Rockford, IL 61107-5639 | 2005-07-12 |
Street Address |
1516 W DEVON AVE |
City | CHICAGO |
State | IL |
Zip Code | 60660-1314 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447530639 | Nalini Ahluwalia, Md Sc | Internal Medicine | 1516 W Devon Ave, Chicago, IL 60660-1314 | 2011-08-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225672280 | Alexis Shelton | Behavior Technician | 6317 N Broadway, Chicago, IL 60660 | 2019-11-03 |
1912470105 | Pipeline - Lakefront Medical Associates, LLC | Family Medicine | 6201 North Broadway, Chicago, IL 60660 | 2019-01-10 |
1417492224 | Aynur Fataliyeva | Non-emergency Medical Transport (VAN) | 5701 N Sheridan Road, Apt 20g, Chicago, IL 60660 | 2017-01-03 |
1285187591 | Bryan Moles | Developmental Therapist | 6157 N Kenmore, Apt #4s, Chicago, IL 60660 | 2016-08-03 |
1144609181 | Ebm Consulting LLC | Anesthesiology | 5600 N Sheridan Road, #115, Chicago, IL 60660 | 2015-05-22 |
1295134112 | Brent E Agran, Dds, LLC | Dentist | 5820 N. Clark St., 1s, Chicago, IL 60660 | 2014-08-15 |
1538573258 | Emily Eaton | Student in an Organized Health Care Education/Training Program | 5643 N. Magnolia Ave, Chicago, IL 60660 | 2014-06-20 |
1538572664 | Rozina Altaf Virani | Nurse Practitioner | 6033 N Sheridan Rd Ste N6, Chicago, IL 60660 | 2014-06-05 |
1548673866 | Emily Mckernan | Social Worker | 5710 N Broadway Ave, Chicago, IL 60660 | 2014-06-04 |
1679902324 | Christopher Burgess | Psychologist | 1554 W Hollywood, #storefront, Chicago, IL 60660 | 2013-11-04 |
Find all providers in zip 60660 |
Taxonomy Code | 2080A0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Adolescent Medicine |
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417259979 | Adolescent and Young Adult Place Ltd | Pediatrics | 9 N Cicero Ave, Chicago, IL 60644-3602 | 2010-12-03 |
1942520671 | Cherie Priya Dhar | Pediatrics | 1440 N Dayton St Fl 3, Chicago, IL 60642-2644 | 2010-06-04 |
1649475377 | Lisa Kantz Simons | Pediatrics | 225 E Chicago Ave # Ms 161b, Chicago, IL 60611-2991 | 2007-06-21 |
1447259759 | Kimberly A. Koval | Pediatrics | 1030 N Clark St, Suite 400, Chicago, IL 60610-5467 | 2005-07-19 |
1235451402 | Felicia Scott | Pediatrics | 1725 W Harrison St, Suite 710, Chicago, IL 60612-3841 | 2010-02-15 |
1124260625 | Sonia Wengerhoff | Pediatrics | 2835 N Sheffield Ave, Suite 501, Chicago, IL 60657-5081 | 2009-03-30 |
1275773475 | My Pediatrics Associates LLC | Pediatrics | 2875 W 19th St, Chicago, IL 60623-3501 | 2009-02-27 |
1528233087 | Nava Segall Md Sc | Pediatrics | 4116 N Lincoln Ave, Chicago, IL 60618-3028 | 2008-04-25 |
1093934275 | The Board of Trustees of The University of Illinois | Pediatrics | 840 S Wood St, Chicago, IL 60612-4325 | 2007-04-25 |
1427107812 | Margo Antoinette Bell | Pediatrics | 1901 W Harrison St, Administration, Suite 1112, Chicago, IL 60612-3714 | 2007-01-09 |
Find all providers in CHICAGO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.