| NPI | 1912473604 |
|---|---|
| Former Legal Business Name | YATIN M SHAH MDSC |
| Entity Type | Organization |
| Authorized Contact | MITI G SHAH Practice Manager 815-726-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2018-10-19 |