# BRAHMA R KONDA, MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306177720
- **Authorized official:** BRAHMA R KONDA (PRESIDENT)
- **Authorized official phone:** (309) 792-6770

## Contact information

- **Practice address:** 1314 10TH ST, SILVIS, IL 61282-1892
- **Practice address phone:** (309) 792-6770
- **Practice address fax:** (309) 792-6772
- **Mailing address:** 1314 10TH ST, P O BOX 245, SILVIS, IL 61282-1892
- **Mailing address phone:** (309) 792-6770
- **Mailing address fax:** (309) 792-6772

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 036-101548 | IL | Yes |

## Other

- **Enumeration date:** 01/25/2010
- **Last updated:** 01/25/2010