Provider Demographics
NPI:1104898345
Name:ZAVERI, SHAILESH C (MD)
Entity type:Individual
Prefix:
First Name:SHAILESH
Middle Name:C
Last Name:ZAVERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E. WOODFIELD RD
Mailing Address - Street 2:SUITE #111
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-301-1212
Mailing Address - Fax:847-301-1277
Practice Address - Street 1:800 E. WOODFIELD RD
Practice Address - Street 2:SUITE #111
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-301-1212
Practice Address - Fax:847-301-1277
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01091181A207R00000X, 207RC0000X
IL036059482207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036059482Medicaid
IN300079390Medicaid
C45809Medicare UPIN