Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shruti Chakravarthy, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1396270146

Shruti Chakravarthy, MD is an Obstetrics/Gynecology in Peoria, Illinois. Qualified in 2017, 9 years ago. Practices with Mmc OB/GYN Faculty Practice Plan, a 32-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
9
Licensed in
IL
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-3024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 036156737 (IL)

Record details

NPI number1396270146
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 28, 2017
Last updated in NPPESJanuary 23, 2025
Certification dateJanuary 23, 2025
Mailing address530 Ne Glen Oak Ave, Peoria, IL 61637-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Mmc Ob/Gyn Faculty Practice Plan — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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