Individual
DR. SATHYA SUBBIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 RICHMOND AVE E STE 3, MATTOON, IL 61938-4652
(217) 234-7000
(217) 234-2060
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
(217) 868-2812
(217) 258-2216
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-104472
IL
207RB0002X
Obesity Medicine (Internal Medicine) Physician
036-104472
IL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036-104472
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104472 1
—
IL
01
—
279500
MEDICARE GROUP
—
01
—
P00382810
RAILROAD MEDICARE
—
Enumeration date
08/05/2006
Last updated
01/22/2024
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