Provider Demographics
NPI:1487801312
Name:SHAH, NEIL (DO)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S ROSELLE RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2925
Mailing Address - Country:US
Mailing Address - Phone:847-985-0600
Mailing Address - Fax:847-985-3786
Practice Address - Street 1:519 S ROSELLE RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2925
Practice Address - Country:US
Practice Address - Phone:847-985-0600
Practice Address - Fax:847-985-3786
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036123054207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine