IndividualActive
Gary Shaw, M.D.
NPI 1912940958 · Otolaryngology/Facial Plastic Surgery Physician · Canton, IL
Provider details
- NPI number
- 1912940958
- Entity type
- Individual
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 109774 (MO)
Practice location
180 S Main St
Canton, IL 61520-2608
Phone: (309) 647-0201
Fax: (309) 649-6880
Mailing address
180 S Main St
Canton, IL 61520-2608
Registry dates
- Enumerated
- 2006-06-14
- Last updated
- 2021-04-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.