DR. JITENDRA J SHAH MD
NPI 1619061827
Pediatrics - Pediatric Cardiology in Peoria, IL

Active since October 03, 2006
420 NE GLEN OAK AVE, SUITE 304, PEORIA, IL 61603(309) 655-3453(309) 655-2938 Get Directions Write a Review

NPPES record last updated: August 28, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Jitendra J Shah Md NPPES

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

DR. JITENDRA J SHAH MD (NPI 1619061827) is an individual pediatric cardiology provider in Peoria, Illinois, licensed in Illinois (036-053972) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1619061827
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameDR. JITENDRA J SHAHCredential: MD
Location Address420 NE GLEN OAK AVE, SUITE 304Peoria, IL 61603-3105
Mailing Address420 Ne Glen Oak Ave, Suite 304Peoria, IL 61603-3105 · (309) 655-3453 · Fax (309) 655-2938
Fax(309) 655-2938
Sole ProprietorNo
Enumeration DateOctober 3, 2006
Last NPPES UpdateAugust 28, 2012
NPI 1619061827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License Licensed in IL · 036-053972
Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

420 NE GLEN OAK AVE, Peoria, IL 61603

Other Identifiers 4

Medicare UPINC45151IL
Medicare ID-Type UnspecifiedL64780IL
Medicare PINIL3270065IL
Medicaid036053972IL

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.

Nurse Practitioner
420 NE GLEN OAK AVE, SUITE 200
PEORIA, IL 61603
Nurse Practitioner
420 NE GLEN OAK AVE
PEORIA, IL 61603
Pediatrics (Pediatric Cardiology)
420 NE GLEN OAK AVE, SUITE 304
PEORIA, IL 61603
Surgery (Pediatric Surgery)
420 NE GLEN OAK AVE, SUITE 201
PEORIA, IL 61603
Clinical Nurse Specialist (Pediatrics)
420 NE GLEN OAK AVE, SUITE 401
PEORIA, IL 61603
Pediatrics (Pediatric Cardiology)
420 NE GLEN OAK AVE, SUITE 301
PEORIA, IL 61603
Pharmacist
420 NE GLEN OAK AVE
PEORIA, IL 61603
Pediatrics (Pediatric Cardiology)
420 NE GLEN OAK AVE, SUITE 304
PEORIA, IL 61603

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 Jitendra Shah's NPI number?

The NPI number for Jitendra Shah is 1619061827. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Jitendra Shah located?

Jitendra Shah practices at 420 NE Glen Oak Ave Suite 304, Peoria, IL 61603. The listed phone number is (309) 655-3453.

What is Jitendra Shah's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

When was this NPI record last updated?

The NPPES record for Jitendra Shah was last updated on August 28, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.