Individual
MADHU DUKKIPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
505 E GRANT ST STE 110, MACOMB, IL 61455-3308
(217) 528-7541
(217) 525-2535
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-109161
IL
207RI0011X
Interventional Cardiology Physician
Primary
036-109161
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109161
—
IL
01
—
086380
HEALTH ALLIANCE
IL
01
—
P00477441
RAILROAD
IL
Enumeration date
07/26/2006
Last updated
03/10/2025
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