Individual
UDAY R SHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W. PARK ST., URBANA, IL 61801-2500
(217) 383-3129
(217) 326-1550
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301089397
MI
208M00000X
Hospitalist Physician
Primary
036124883
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992901185
—
MI
01
—
3932056
BCBS
IL
01
—
721089
AETNA
IL
Enumeration date
06/25/2007
Last updated
07/29/2015
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