NPI 1154336691

Shobha Nookala, MD

Practitioner Child & Adolescent Psychiatry Physician Peoria, IL

Practice location

Address: 900 Main St Suite 400, Peoria, IL 61602-1005
Phone: (309) 672-3100
Mailing address: 5100 Reliable Pkwy, Chicago, IL 60686-0001

Registered specialties

Child & Adolescent Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0804X

Other Psychiatry & Neurology providers in Illinois →

Registry record

NPI: 1154336691
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Jul 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.