Individual
SHAHID WAZIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
112 NE CRESCENT AVE, PEORIA, IL 61606-1901
(309) 672-4670
Mailing address
112 NE CRESCENT AVE, PEORIA, IL 61606-1901
(309) 672-4670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57008431
OH
207RC0000X
Cardiovascular Disease Physician
Primary
036124816
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036124816
LICENSE
IL
Enumeration date
11/05/2007
Last updated
04/20/2022
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