| Dr Pradip Shah, MD | |
|
200 E Fairman Ave, Watseka, IL 60970-1644 | |
| (630) 321-8300 | |
| (630) 321-8750 |
| Full Name | Dr Pradip Shah |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 200 E Fairman Ave, Watseka, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891789244 | NPI | - | NPPES |
| 036-055221 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036-055221 (Illinois) | Primary |
| Entity Name | Iroquois Memorial Hospital And Resident Home |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629003470 PECOS PAC ID: 4385551258 Enrollment ID: O20040517000306 |
| Entity Name | Aurora Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407379423 PECOS PAC ID: 1850657180 Enrollment ID: O20171102000998 |
| Entity Name | Statera Health Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043874449 PECOS PAC ID: 0244565729 Enrollment ID: O20190708000284 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Pradip Shah, MD 150 Quail Ridge Dr, Westmont, IL 60559-6142 Ph: (630) 321-8300 | Dr Pradip Shah, MD 200 E Fairman Ave, Watseka, IL 60970-1644 Ph: (630) 321-8300 |
Iftekhar A. Awan, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 200 E Fairman Ave, Watseka, IL 60970 Phone: 815-432-5841 | |
Kathleen O. Halleran, D.O. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 200 E Fairman Ave, Watseka, IL 60970 Phone: 630-321-8300 Fax: 630-321-8750 | |
Dr. John A. Timmons, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 200 E Fairman Ave, Watseka, IL 60970 Phone: 630-321-8300 Fax: 630-321-8750 | |
Vijay Desai, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 200 E Fairman Ave, Watseka, IL 60970 Phone: 630-321-8300 Fax: 630-321-8750 | |
M. Hytham Beck, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 200 E Fairman Ave, Watseka, IL 60970 Phone: 815-432-5411 |