Individual
SHUKTI GHULYANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2500
(217) 255-9646
(217) 326-1777
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6941
(217) 326-1777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036125536
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036125536
IL
Other
Enumeration date
04/24/2008
Last updated
05/05/2025
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