Individual
DR. SHANE RAINEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2274
Mailing address
4005 W CARROUSEL LN, PEORIA, IL 61615-2860
(630) 882-5719
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.144466
IL
Other
Enumeration date
05/02/2015
Last updated
01/07/2019
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