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DR. SUZAN CATHLEEN SHANE-GRAY APN, EDD
NPI 1144525452
Clinical Nurse Specialist - Pediatrics in Peoria, IL

Active since January 18, 2011
530 NE GLEN OAK AVE, POB 113, PEORIA, IL 61637(309) 224-8683 Get Directions Write a Review

NPPES record last updated: January 18, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Suzan Cathleen Shane-gray Apn, Edd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUZAN CATHLEEN SHANE-GRAY APN, EDD (NPI 1144525452) is an individual pediatrics provider in Peoria, Illinois, licensed in Illinois (209.008562) and active in the NPI registry since January 2011.

NPPES Registry Identity

NPI1144525452
Entity TypeIndividualFemale
Primary Taxonomy364SP0200X
Provider Legal NameDR. SUZAN CATHLEEN SHANE-GRAYCredential: APN, EDD
Location Address530 NE GLEN OAK AVE, POB 113Peoria, IL 61637-0001
Mailing Address530 Ne Glen Oak Ave, Pob 113Peoria, IL 61637-0001 · (309) 224-8683
Phone(309) 224-8683
Sole ProprietorNo
Enumeration DateJanuary 18, 2011
✔ NPI 1144525452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0200X
License✔ Licensed in IL · 209.008562
530 NE GLEN OAK AVE, Peoria, IL 61637
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPAK S NAIR M.D.
Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ERIC TYLER AMPARAN MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2274
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Suzan Shane-gray's NPI number?

The NPI number for Suzan Shane-gray is 1144525452. It was assigned to this individual provider in the NPPES registry on January 18, 2011.

Where is Suzan Shane-gray located?

Suzan Shane-gray practices at 530 NE Glen Oak Ave Pob 113, Peoria, IL 61637. The listed phone number is (309) 224-8683.

What is Suzan Shane-gray's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Pediatrics, with taxonomy code 364SP0200X.

When was this NPI record last updated?

The NPPES record for Suzan Shane-gray was last updated on January 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.