Individual
ANUSHI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
6021 N IMPERIAL DR APT 141, PEORIA, IL 61614-3953
(512) 921-7850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125.064983
IL
208000000X
Pediatrics Physician
125.064983
IL
Other
Enumeration date
06/29/2014
Last updated
06/29/2014
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