Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036.117934 | IL |
N | 208600000X | Surgeon | 036.117934 | IL |
Y | 2086S0120X | Pediatric Surgery | 036117934 | IL |
NPI | 1578651899 |
---|---|
Provider Name | Ami N. Shah |
First Address | Chicago, IL 60612-3833 |
Second Address | Chicago, IL 60612-3833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 20/01/2022 |