Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ketan Mahendra Shah, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1689959900

Mr. Ketan Mahendra Shah, PMHNP-BC is a Nurse Practitioner in Wheaton, Illinois. Graduated from Rush Medical College of Rush University in 2010, 16 years ago. Practices with County of Dupage Department of Health, a 31-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
16
Trained at
Rush Medical College of Rush University
Licensed in
IL
In the registry since
2011
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

111 N County Farm Rd
Wheaton, IL 60187-3977
Phone: (630) 682-7400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209008868 (IL)

Record details

NPI number1689959900
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedOctober 18, 2011
Last updated in NPPESOctober 5, 2021
Certification dateOctober 5, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolRUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated 2010 (16 years in practice)
Group practice County Of Dupage Department Of Health — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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