Individual
CHANDRA KANTH CHATURVEDULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PROFESSIONAL PLZ, MATTOON, IL 61938-9280
(309) 676-8123
(309) 676-8455
Mailing address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 624-9259
(309) 676-8455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036146437
IL
207RN0300X
Nephrology Physician
Primary
036.146437
IL
Other
Enumeration date
07/16/2015
Last updated
01/15/2025
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