Individual
DR. SUSHMA SHIVANANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 NE GLEN OAK, PEORIA, IL 61637
(309) 624-4100
Mailing address
530 NE GLEN OAK, PEORIA, IL 61637
(309) 624-4100
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
036176593
IL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
125.082886
IL
Other
Enumeration date
07/18/2023
Last updated
03/06/2026
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