Individual
SHIRAZ KHAISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 MAIN ST, SUITE 500A, PEORIA, IL 61606-2038
(309) 672-4980
(309) 671-2979
Mailing address
4826 N WEAVERRIDGE BLVD, PEORIA, IL 61615-8946
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME 104853
FL
207RG0100X
Gastroenterology Physician
Primary
036134402
IL
Other
Enumeration date
04/25/2007
Last updated
07/12/2019
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