IndividualActive
Nishant Shah, MD
NPI 1043254980 · Neurology with Special Qualifications in Child Neurology Physician · Park Ridge, IL
Provider details
- NPI number
- 1043254980
- Entity type
- Individual
- Primary specialty
- Neurology with Special Qualifications in Child Neurology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 036-095353 (IL)
Specialties & taxonomies
- Neurology with Special Qualifications in Child Neurology PhysicianPrimary2084N0402XLicense 036-095353 (IL)
Allopathic & Osteopathic Physicians
Practice location
1675 Dempster St
Park Ridge, IL 60068-1110
Phone: (847) 723-5962
Fax: (847) 723-2325
Approximate (ZIP-level) locationGet directions
Mailing address
3217 Brandess Dr
Glenview, IL 60026-1177
Registry dates
- Enumerated
- 2006-06-15
- Last updated
- 2021-12-17
- Certified
- 2021-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.