IndividualActive
Vimal Master Sankar Raj, MD
NPI 1336339597 · Pediatric Nephrology Physician · Peoria, IL
Provider details
- NPI number
- 1336339597
- Entity type
- Individual
- Primary specialty
- Pediatric Nephrology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 036133119 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
530 Ne Glen Oak Ave
Peoria, IL 61637-3105
Phone: (309) 624-8884
Approximate (ZIP-level) locationGet directions
Mailing address
530 Ne Glen Oak Ave
Peoria, IL 61637-0001
Registry dates
- Enumerated
- 2007-07-25
- Last updated
- 2016-04-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.