Provider Demographics
NPI:1235709429
Name:MAHESHWARI, JAINIL (MD)
Entity type:Individual
Prefix:
First Name:JAINIL
Middle Name:
Last Name:MAHESHWARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 NE GLEN OAK AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61637-0001
Mailing Address - Country:US
Mailing Address - Phone:309-624-8818
Mailing Address - Fax:309-624-8820
Practice Address - Street 1:530 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61637-0001
Practice Address - Country:US
Practice Address - Phone:309-624-8818
Practice Address - Fax:309-624-8820
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2025-09-18
Deactivation Date:2023-04-06
Deactivation Code:
Reactivation Date:2023-04-26
Provider Licenses
StateLicense IDTaxonomies
IL125.078155207R00000X
IL036169626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine