DR. MIRAJ G SHAH-KHAN (NPI# 1407007958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407007958 |
| Entity Type | Individual |
| Full Name | DR. MIRAJ G SHAH-KHAN |
| Credential | M.D. |
| Practice Address |
15300 West Ave Orland Park IL 60462-4600 |
| Mailing Address |
12251 S 80th Ave Ste 1630 Palos Heights IL 60463-1256 |
| Practice Telephone | 7085905520 |
| Practice Fax Number | 7085905524 |
| Mailing Telephone | 7089235173 |
| Mailing Fax Number | 7089235018 |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2020-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036-121447 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
036121447 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 36121447 | 05 |
| Street Address |
15300 WEST AVE |
| City | ORLAND PARK |
| State | IL |
| Zip Code | 60462-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804628 | John G Hohner | Neuromusculoskeletal Medicine & OMM | 15300 West Ave, Orland Park, IL 60462-4600 | 2005-07-07 |
| 1508463969 | Brianna Panka | Social Worker | 15300 West Ave, Orland Park, IL 60462-4600 | 2020-10-07 |
| 1275157133 | Lauren Renee Zuro | Dietitian, Registered | 15300 West Ave, Orland Park, IL 60462-4600 | 2020-06-05 |
| 1942751664 | Michelle Marie Hartnett | Physician Assistant | 15300 West Ave, Suite 20 South, Orland Park, IL 60462-4600 | 2016-10-18 |
| 1003295338 | Andrea Jean Moormann | Occupational Therapist | 15300 West Ave, West Bldg., Suite 310, Orland Park, IL 60462-4600 | 2015-05-19 |
| 1073909123 | Eugenia Kyriakopoulos | Family Medicine | 15300 West Ave, Orland Park, IL 60462 | 2015-04-15 |
| 1962892232 | Mary A Merlo | Nurse Practitioner | 15300 West Ave, Orland Park, IL 60462-4600 | 2015-01-26 |
| 1063814796 | Oral & Maxillofacial Surgery of Chicago | Dentist | 15300 West Ave, Orland Park, IL 60462-4600 | 2014-09-25 |
| 1881008472 | Robin Lee Gallardi | Dentist | 15300 West Ave, Suite 113, Orland Park, IL 60462-4600 | 2014-06-11 |
| 1275954117 | Mary T Rhodes I | Nurse Practitioner | 15300 West Ave, Orland Park, IL 60462-4600 | 2013-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083257331 | Stephanie Slager | Behavioral Analyst | 8430 W 135th St., Orland Park, IL 60462 | 2019-10-18 |
| 1730652587 | Nancy Lynch | Speech-Language Pathologist | 15100 S 94th Ave Orland School District 135, Orlond Park, IL 60462 | 2019-01-04 |
| 1932681327 | Alyssa Avant | Speech-Language Pathologist | 8851 W 151st St, Orland Park, IL 60462 | 2018-08-31 |
| 1922588110 | Pain Specialists of Greater Chicago S C | Pain Medicine | 15300 West Ave Ste C213, Orland Park, IL 60462 | 2018-08-16 |
| 1689168478 | S- R&r Counseling Inc. | Counselor | 9750 Crescent Park Cir Unit 306, Orland Park, IL 60462 | 2018-06-15 |
| 1104372952 | Amy Blanks | Nurse Anesthetist, Certified Registered | 13959 95th Avenue, Orland Park, IL 60462 | 2016-08-31 |
| 1740632454 | Anna S Wang | Optometrist | 14494 John Humphrey Dr, Orland Park, IL 60462 | 2016-07-06 |
| 1750739793 | Carolyn Sluis | Pharmacist | 9352 W 159th Street, Orland Park, IL 60462 | 2016-06-01 |
| 1164882262 | Caring Hands Group Home of Il, Inc. | Community/Behavioral Health | 14475 John Humphrey Dr., Orland Park, IL 60462 | 2016-03-02 |
| 1639539760 | Frazierworks Community Care, Inc. | In Home Supportive Care | 14475 John Humphrey Dr Suite 300, Orland Park, IL 60462 | 2016-03-02 |
| Find all providers in zip 60462 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205093697 | Myles P Cunningham | Surgery | 31 Woodley Road, Winnetka, IL 60093 | 2008-05-22 |
| 1225237704 | Roger Hoon Kim | Surgery | 315 W Carpenter St Fl C2, Springfield, IL 62702-4901 | 2007-07-13 |
| 1033162839 | Mark M. Connolly | Surgery | 2913 N Commonwealth Ave, 5th Floor, Chicago, IL 60657-6211 | 2006-05-19 |
| 1942272968 | Charles K Brown | Surgery | 5201 Willow Springs Rd Ste 290, La Grange Highlands, IL 60525-6506 | 2006-02-03 |
| 1114913225 | Thomas H Tarter | Surgery | 210 W Mckinley Ave Ste 1, Decatur, IL 62526-5858 | 2005-09-23 |
| 1396739280 | Sonya M Sharpless | Surgery | 660 N Westmoreland Rd Ste 303, Lake Forest, IL 60045-1659 | 2005-09-07 |
| 1588662928 | Swati Kulkarni | Surgery | 250 E Superior St, Suite 420, Chicago, IL 60611-2914 | 2005-07-11 |
| 1760868871 | Presence Central and Suburban Hospitals Network | Surgery | 333 Madison St, Joliet, IL 60435-8200 | 2015-07-31 |
| 1235424656 | Fadi Suhail Dahdaleh | Surgery | 5841 S. Maryland Avenue, M/c 6040, Chicago, IL 60637 | 2011-06-14 |
| 1396062253 | Akhil Chawla | Surgery | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2010-04-30 |
| Find all providers with the same taxonomy | ||||
| City | ORLAND PARK |
| Zip Code | 60462 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.