Shelby L. Chan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209-019301 Issued in IL

Practice address

8600 State Route 91 Ste 250
Peoria, IL 61615-7831

Phone

(309) 692-5393

NPI assigned

Apr 18, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shelby Wallace Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Associated Anesthesiologists SCGroup PAC ID 6305744129, 150 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Associated Anesthesiologists, S.C.

  • Anesthesiology Physician
  • Peoria, IL
  • NPI 1558306480
  Medicare reassignment Care Compare group NPD
• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Medicare reassignment Care Compare group NPD
• Associated Anesthesiologists, SC

  • Anesthesiology Physician
  • Peoria, IL
  • NPI 1023612082
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1982267696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 STATE ROUTE 91 STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157831",
            "telephone_number": "309-692-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 STATE ROUTE 91 STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157831",
            "telephone_number": "309-692-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SHELBY",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-019301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "WALLACE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Marie Champion, MS
• Andrew Oakford Champion, PT
• Daniel Chan, MD, PHD
• David P Chan, MD
• Edwin Yue-Hang Chan, M.D.
• Tamra Joy Chan, MSN, APN, FNP-BC
• Kiran Kishor Chandrasekar, M.B.B.S
• Jennifer Lorraine Chaney, APN
• Alexander Chang
• Henry Tze Hin Chang, MD

• Certified Registered Nurse Anesthetist in Peoria, IL
• Providers in Peoria, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.