Organization
SRINIVASAN S PURIGHALLA
Active
Other names
PURIGHALLA NEUROSCIENCE & SPINE INSTITUTE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVASAN S PURIGHALLA MD (PRESIDENT)
(309) 517-3775
Entity
Organization
Contact information
Practice address
616 35TH AVE STE 1, MOLINE, IL 61265-6158
(309) 517-3775
(309) 517-3625
Mailing address
616 35TH AVE STE 1, MOLINE, IL 61265-6158
(309) 517-3775
(309) 517-3625
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036111101
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111101
—
IL
01
—
DC0079
MEDICARE RAILROAD
IL
Enumeration date
01/16/2006
Last updated
04/17/2015
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