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Individual

DR. NEETA B KAUSHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4107 N WATER TOWER PL, MOUNT VERNON, IL 62864-6296
(618) 242-5437
Mailing address
4107 N WATER TOWER PL, MOUNT VERNON, IL 62864-6296
(618) 242-5437

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036094868
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036094868
IL
01
207988
GROUP
IL
01
CE9335
RR GROUP NUMBER
IL
01
P00345211
RR MEDICARE NUMBER
IL
Enumeration date
04/06/2006
Last updated
04/20/2012
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