SHAHID WAZIR (NPI# 1548440803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548440803 |
| Entity Type | Individual |
| Full Name | SHAHID WAZIR |
| Credential | MD |
| Practice Address |
112 Ne Crescent Ave Peoria IL 61606-1901 |
| Practice Telephone | 3096724670 |
| Mailing Telephone | 3096724670 |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2019-12-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 57008431 | OH | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036124816 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE | 036124816 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 Metrohealth Dr, Cleveland, OH 441091900 | 2167787800 |
| Street Address |
112 NE CRESCENT AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265485973 | Heartland Home Health Care Inc. | Prosthetic/Orthotic Supplier | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2006-05-17 |
| 1265070494 | Aaron M Owens | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2019-12-18 |
| 1881151538 | Heather Franklin | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2019-02-28 |
| 1558830851 | Courtney D Edsall | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2018-11-15 |
| 1285142281 | Matthew Culp | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2018-01-12 |
| 1063936573 | Cheryl Herrmann | Clinical Nurse Specialist | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-07-27 |
| 1225566334 | Jodi Nutter | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-06-02 |
| 1063720993 | Pawan Damodhar Sarda | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2010-09-14 |
| 1053563643 | Nicholas Warnecke | Physician Assistant | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2008-10-15 |
| 1194974964 | Tahir Ilahi | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2008-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| Find all providers in zip 61606 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558553016 | Ashim Aggarwal | Internal Medicine | 13634 N 93rd Ave Ste 300, Peoria, AZ 85381 | 2007-08-17 |
| 1174672331 | Thanad S Shay | Internal Medicine | 1201 N North St, Peoria, IL 61606-1533 | 2007-01-09 |
| 1568558492 | Barry Rosen | Internal Medicine | 28685 N. 129th Ave, Peoria, AZ 85383 | 2006-10-05 |
| 1265535116 | Frank Gold | Internal Medicine | 112 Crescent Avenue, Peoria, IL 61603 | 2006-09-06 |
| 1912929118 | Alexander Adler | Internal Medicine | 112 Ne Crescent, 2nd Floor, Peoria, IL 61603 | 2006-07-24 |
| 1588691877 | Joseph J Sarmiento IIi | Internal Medicine | 5405 North Knoxville Avenue, Peoria, IL 61614 | 2006-06-26 |
| 1265407399 | Cardiac Consultants Sc | Internal Medicine | 900 Main Street, Suite 320, Peoria, IL 61602 | 2006-02-22 |
| 1649268723 | Gabor S Jilly | Internal Medicine | 13128 N 94th Dr, No 100, Peoria, AZ 85381-4252 | 2005-10-12 |
| 1003804170 | Manoj Rawal | Internal Medicine | 13460 N 94th Drive, Ste J-1, Peoria, AZ 85381-4246 | 2005-10-12 |
| 1134121825 | Marc A Petein | Internal Medicine | 13634 N 93rd Ave, Suite 300, Peoria, AZ 85381-4915 | 2005-08-11 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.