DR. SYED AHMED SHAH (NPI# 1508867300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508867300 |
| Entity Type | Individual |
| Full Name | DR. SYED AHMED SHAH |
| Credential | M.D. |
| Practice Address |
1007 Ml King Dr Suite 1 Centralia IL 62801-3003 |
| Mailing Address |
Po Box 431 Centralia IL 62801-9107 |
| Practice Telephone | 6185339577 |
| Practice Fax Number | 6185339588 |
| Mailing Telephone | 6185339577 |
| Mailing Fax Number | 6185339588 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2019-03-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036097235 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 929 Stacey Burk Dr, Flora, IL 628393241 | 6185339577 | 6185339588 |
| 1007 S 42nd St Ste 2, Mount Vernon, IL 628646217 | 6182419587 | 6182419589 |
| 705 S Grand St, Nashville, IL 622631534 | 6185339577 | 6185339588 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679198857 | Syed Fazal Shah | Nurse Practitioner | 719 Harrison St Rm 126, Syracuse, NY 13210-2305 | 2020-06-12 |
| 1336504745 | Syed Zubairuddin Shah | Pharmacist | 6630 Fm 1463 Rd., Suite 400-a, Katy, TX 77494 | 2015-12-30 |
| 1245318443 | Syed T Shah | Internal Medicine | 345 First South Street, Winthrop, IA 50682 | 2006-11-02 |
| 1811077738 | Syed Rizwan Shah | Specialist | 2746 Matlock Rd, Ste 100, Arlington, TX 76015-2531 | 2006-10-16 |
| 1760496152 | Syed M Shah | Physical Medicine & Rehabilitation | 435 59th St, West New York, NJ 07093-2107 | 2006-07-28 |
| 1720039480 | Syed Nayyar Shah | Internal Medicine | 1900 Mistletoe Blvd Ste 100, Fort Worth, TX 76104-4048 | 2006-05-15 |
| 1568435725 | Syed G Shah | Internal Medicine | 693 Port Carbon Saint Clair Hwy, Pottsville, PA 17901-8604 | 2006-02-08 |
| 1275514218 | Syed Asif Shah | Internal Medicine | 7600 S Minnesota Ave, Sioux Falls, SD 57108 | 2005-11-08 |
| 1407365554 | Syed Shah | Student in an Organized Health Care Education/Training Program | 29 E 29th St, Bayonne, NJ 07002-4654 | 2017-09-20 |
| 1205357688 | Syed Raza Shah | Internal Medicine | 1147 Nw 64th Ter, Gainesville, FL 32605-4218 | 2017-07-06 |
| Street Address |
1007 ML KING DR SUITE 1 |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740494590 | Sajjan K Nemani Md Sc | Psychiatry & Neurology | 1054 M L King Dr Ste 124, Centralia, IL 62801-3065 | 2007-05-10 |
| 1649220542 | Sajjan K Nemani | Psychiatry & Neurology | 1054 Martin Luther King, Suite 124, Centralia, IL 62801 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831714294 | Kaitlin E Keenan | Psychiatry & Neurology | 600 S Paulina St Ste 403aac, Chicago, IL 60612-3806 | 2020-06-11 |
| 1811546484 | Glencor Neuromonitoring LLC | Psychiatry & Neurology | 611 S Milwaukee Ave Ste 8, Libertyville, IL 60048-3256 | 2019-09-06 |
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1972167906 | Kazkaz Southwest Neurology S.c. | Psychiatry & Neurology | 1890 Silver Cross Blvd Ste 320, New Lenox, IL 60451-9610 | 2019-04-25 |
| 1285195594 | Niccolo Emanuele Mencacci | Psychiatry & Neurology | 303 E Chicago Ave # 12-226, Chicago, IL 60611-4296 | 2019-03-28 |
| 1497216865 | Juan Pablo Ospina Botero | Psychiatry & Neurology | 5841 S Maryland Ave # 2030s231, Chicago, IL 60637-1443 | 2019-03-28 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1124526272 | Neurology Clinic of Chicago, LLC | Psychiatry & Neurology | 4909 W Division St Ste 302, Chicago, IL 60651-3161 | 2018-01-23 |
| 1538514120 | Kathleen Mary Gorman | Psychiatry & Neurology | 225 E Chicago Avenue, Chicago, IL 60611 | 2016-05-02 |
| 1396190203 | Lauren Brandes | Psychiatry & Neurology | 1725 W Harrison St Ste 309, Chicago, IL 60612-3844 | 2016-04-28 |
| Find all providers with the same taxonomy | ||||
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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.