Individual
UMA SRIVASTAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4920 E STATE ST, ROCKFORD, IL 61108-2272
(815) 226-1906
(815) 226-8474
Mailing address
4920 EAST STATE ST, ROCKFORD, IL 61108-2262
(815) 226-1906
(815) 226-8474
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036061178
IL
Other
Enumeration date
10/13/2006
Last updated
05/03/2016
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