Individual
SUBHASH C CHAUDHARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 N 8TH ST STE 4A, SPRINGFIELD, IL 62701-1013
(217) 545-8000
(217) 545-5018
Mailing address
PO BOX 19658, SPRINGFIELD, IL 62794-9658
(217) 545-8000
(217) 545-5018
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036-055782
IL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
036-055782
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055782
—
IL
Enumeration date
12/05/2005
Last updated
09/27/2018
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