Individual
PRAYAG D SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
575 S PERRYVILLE RD STE 119, ROCKFORD, IL 61108-2530
(847) 571-0402
Mailing address
575 S PERRYVILLE RD, ROCKFORD, IL 61108-2530
(847) 571-0402
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009516
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009516
—
IL
Enumeration date
08/31/2005
Last updated
01/26/2026
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