Individual
VIKRAM S KOTWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1750 E LAKE SHORE DR, SUITE 310, DECATUR, IL 62521-3803
(217) 464-1220
(217) 464-1229
Mailing address
1750 E LAKE SHORE DR, SUITE 310, DECATUR, IL 62521-3803
(217) 464-1220
(217) 464-1229
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.052336
IL
207RG0100X
Gastroenterology Physician
Primary
036-126060
IL
Other
Enumeration date
01/08/2010
Last updated
07/10/2013
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