| Dr Jitendra J Shah, MD | |
|
420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | |
| (309) 655-3453 | |
| (309) 655-2938 |
| Full Name | Dr Jitendra J Shah |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Cardiology |
| Location | 420 Ne Glen Oak Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619061827 | NPI | - | NPPES |
| 036053972 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0202X | Pediatrics - Pediatric Cardiology | 036-053972 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jitendra J Shah, MD 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 Ph: (309) 655-3453 | Dr Jitendra J Shah, MD 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 Ph: (309) 655-3453 |
Thomas James Mcmorrow, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602 | |
Jessica Ford-davis, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2274 | |
Kelsey Elizabeth Grimes, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Jessica N Mistretta, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Mrs. Valeria Claudia Benavides Lopez, M.D., M.P.H. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-3313 | |
Khalid Al Katranji, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-7171 | |
Dr. Gretchen L Kopec, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-0615 |