Individual
DR. VIJETA SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801
(217) 383-3311
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
(217) 902-5291
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036150115
IL
2084N0400X
Neurology Physician
036150115
IL
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
036150115
IL
Other
Enumeration date
07/13/2012
Last updated
04/21/2025
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