| Doctor Name: | NISHANT SHAH |
| NPI Number: | 1043254980 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 1675 Dempster St Park Ridge, IL - 600681110 |
| Business Phone Number: | 8477235962 |
| Business Fax Number: | 8477232325 |
| Mailing Address: | 3217 Brandess Dr, GLENVIEW |
| State: | IL |
| Postal Code: | 600261177 |
| Phone Number: | 8477235962 |
| Fax Number: | 8477232325 |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084N0402X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Neurology with Special Qualifications in Child Neurology |
| Taxonomy Definition: | A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |