Provider Demographics
NPI:1235624727
Name:SHAHID, MAHUM (MD)
Entity type:Individual
Prefix:DR
First Name:MAHUM
Middle Name:
Last Name:SHAHID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 W CONGRESS PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3833
Mailing Address - Country:US
Mailing Address - Phone:312-942-5904
Mailing Address - Fax:605-322-8414
Practice Address - Street 1:1653 W CONGRESS PKWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-942-5904
Practice Address - Fax:605-322-8414
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2025-07-28
Deactivation Date:2019-02-13
Deactivation Code:
Reactivation Date:2019-02-19
Provider Licenses
StateLicense IDTaxonomies
IL036173282207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist