Shane Michael Peck, PHARMD

Pharmacist · Anna, IL

Individual Active NPI

NPI number 1710587175

Practice location

300 Leigh Ave
Anna, IL 62906-2213
Phone
(618) 833-8580

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NPI record

NPI
1710587175
Entity type
Individual (Type 1)
Enumeration date
October 27, 2020
Last updated
October 27, 2020
Certified
October 27, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacist Primary 183500000X 051299014 IL

Mailing address

175 Tollgate Rd
Anna, IL 62906-5400

About Dr. Peck

Shane Michael Peck, PHARMD is a healthcare provider registered in the NPI registry with the primary taxonomy Pharmacist (code 183500000X). The practice location is 300 Leigh Ave, Anna, IL 62906-2213. The NPI number 1710587175 was assigned on October 27, 2020 and the record was last updated on October 27, 2020.

Dr. Peck lists a license in the registry: #051299014 (IL) for Pharmacist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Shane Michael Peck, PHARMD?

The NPI number is 1710587175.

What is the phone number of Dr. Peck?

The phone number listed for the practice location is (618) 833-8580.

Where is Dr. Peck located?

300 Leigh Ave, Anna, IL 62906-2213.

What is the taxonomy code for Dr. Peck?

The primary taxonomy code is 183500000X – Pharmacist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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