Provider Demographics
NPI:1275682445
Name:DRS. SHAY AND ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:DRS. SHAY AND ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-671-2310
Mailing Address - Street 1:1201 N NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61606-1533
Mailing Address - Country:US
Mailing Address - Phone:309-671-2310
Mailing Address - Fax:
Practice Address - Street 1:1201 N NORTH ST
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61606-1533
Practice Address - Country:US
Practice Address - Phone:309-671-2310
Practice Address - Fax:309-674-3560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036048357207RC0000X
IL036049845207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCL3221OtherRAILROAD MEDICARE ID
1275682445OtherNPI
1275682445OtherNPI