Individual
MAHAM SHAHID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8600 IL-91 STE 130, PEORIA, IL 61615
(309) 683-5050
Mailing address
8600 IL - 91 STE 130, PEORIA, IL 61615
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.172001
IL
207R00000X
Internal Medicine Physician
Primary
036172001
IL
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
036.172001
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/29/2021
Last updated
11/18/2024
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