Nookala, Shobha

Nookala, Shobha is an individual health care provider with primary practice located at 900 Main St Suite 400, Peoria IL 61602-1005. She recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as her primary health care specialty. Nookala, Shobha can be contacted via phone (309) 672-3100.

Contact Information

Primary practice address
900 Main St Suite 400 Peoria IL 61602-1005
Phone: (309) 672-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X Illinois

Profile Details

NPI number 1154336691
LBN Legal business name Nookala, Shobha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154336691 NPPES
Illinois Other 088318 HEALTH ALLIANCE
Illinois Other 472292 HEALTH ALLIANCE
Illinois Other 7215059 HEALTH ALLIANCE

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