DR. KUNVARJI GANGJI SHAH (NPI# 1154512127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154512127 |
| Entity Type | Individual |
| Full Name | DR. KUNVARJI GANGJI SHAH |
| Credential | MD |
| Practice Address |
802 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 3096923630 |
| Mailing Telephone | 3096923630 |
| Mailing Fax Number | 3096923790 |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 07200478 | 01 |
| Street Address |
802 W TRAILCREEK DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-1862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285802678 | Jenny Kunvarji Shah | Nurse Anesthetist, Certified Registered | 802 W Trailcreek Dr, Cosmetic Surgery Care, Peoria, IL 61614-1862 | 2008-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1538498209 | Dr. Richard D. Corley, S.c. | Plastic Surgery | 416 St. Mark Ct., #106, Peoria, IL 61603-1928 | 2009-12-09 |
| 1801914882 | Richard D Corley | Plastic Surgery | 808 W Trailcreek Dr, Peoria, IL 61614-1862 | 2007-03-27 |
| 1780709394 | Jason D Johnson | Plastic Surgery | 15396 N 83rd Ave Ste B100, Peoria, AZ 85381-5626 | 2007-03-20 |
| 1356344626 | Brian B Bruggeman | Plastic Surgery | 14155 N. 83rd Ave, Suite 147, Peoria, AZ 85381 | 2005-05-31 |
| 1538162201 | Martin Lloyd Johnson | Plastic Surgery | 13090 N 94th Dr, Suite 101, Peoria, AZ 85381-4256 | 2005-05-24 |
| 1629416920 | Tyler Andrew Evans | Plastic Surgery | 1001 Main St Ste 300, Peoria, IL 61606-2036 | 2013-06-07 |
| 1366462475 | Glyn E. Jones | Plastic Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-07-20 |
| 1417923517 | John E Lomax | Plastic Surgery | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 | 2006-02-27 |
| 1356336317 | Michael N Desvigne | Plastic Surgery | 9165 W Thunderbird Rd, Suite 100, Peoria, AZ 85381-4847 | 2005-09-15 |
| 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.