Mattai, Shanta D.
Mattai, Shanta D. is an individual health care provider with primary practice located at 100 Ne Randolph Ave , Peoria IL 61606-1919. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Mattai, Shanta D. can be contacted via phone (309) 624-8500.Contact Information
Primary practice address
100 Ne Randolph Ave
Peoria IL 61606-1919
Phone: (309) 624-8500
Fax: (309) 655-8552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | Illinois |
Profile Details
| NPI number | 1609974096 |
|---|---|
| LBN Legal business name | Mattai, Shanta D. |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 14th, 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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