DR SHRESTHA MD SC NPI 1699045740

NPI Information

  • NPI: 1699045740
  • Provider Name: DR SHRESTHA MD SC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • CLIA Number: 14D2037211
  • Address: 1050 M L KING DR
    SUITE 111
    CENTRALIA, IL
    ZIP 62801
  • Phone: (567) 868-4507

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NPI Details

DR SHRESTHA MD SC is a clinic center in Centralia, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DR SHRESTHA MD SC NPI is 1699045740. The provider is registered as an organization entity type.

The provider's business location address is:

1050 M L KING DR
SUITE 111
CENTRALIA, IL
ZIP 62801-060
Phone: (567) 868-4507
Fax: (877) 397-7287

The provider's authorized official is Niranjan Shrestha .
The authorized official title is President and has the following contact phone number (567) 868-4507.

The CLIA number assigned to this NPI record is 14D2037211 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2012 and was last updated on 1/6/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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