Individual
JIGNESH MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1730 E LAKE SHORE DR, DECATUR, IL 62521-3809
(217) 329-1000
(217) 545-0825
Mailing address
1730 E LAKE SHORE DR, DECATUR, IL 62521-3809
(217) 329-1000
(217) 545-0825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.125721
IL
207RI0200X
Infectious Disease Physician
Primary
036.125721
IL
208M00000X
Hospitalist Physician
036.125721
IL
Other
Enumeration date
06/25/2010
Last updated
01/06/2022
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