Individual
SWETHA VENNAVARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
OSF SAINT FRANCIS MEDICAL CTR, 530 NE GLEN OAK AVENUE, PEORIA, IL 61637-0001
(309) 624-9361
Mailing address
9711 N MEGAN CT, PEORIA, IL 61615-7475
(309) 573-5035
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125062491
IL
2084N0400X
Neurology Physician
Primary
036141852
IL
Other
Enumeration date
02/08/2013
Last updated
10/24/2023
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