PRABODH C SHAH M.D. NPI 1316935240

NPI Information

NPI: 1316935240
Provider Name: PRABODH C SHAH, M.D.
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Address:
2800 W 95TH ST
CANCER CENTER
EVERGREEN PARK, IL
ZIP 60805
Phone: (708) 229-6020
Get Directions

Prabodh C Shah, M.D. is a hematology and oncology internal medicine in Evergreen Park, IL. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Prabodh C Shah, M.D. NPI is 1316935240. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2800 W 95TH ST
CANCER CENTER
EVERGREEN PARK, IL
ZIP 60805-701
Phone: (708) 229-6020
Fax: (708) 229-6083

The enumeration date for this NPI number is 10/13/2005 and was last updated on 6/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RH0003X	Internal Medicine	Hematology & Oncology	A25747	CALIFORNIA	No
2	207RH0003X	Internal Medicine	Hematology & Oncology	036042091	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036042091	MEDICAID	ILLINOIS
2	036042091	OTHER	ILLINOIS	LICENSE
3	D12466	MEDICARE UPIN
4	00A257470	MEDICAID	CALIFORNIA
5	BF472Z	MEDICARE PIN	CALIFORNIA
6	M050376	OTHER	CALIFORNIA	GROUP
7	T01700	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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