Individual
NAGESWARARAO VALLABHANENI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD PSYCHIATRIST
Contact information
Practice address
1315 LEHMEN DR, CHESTER, IL 62233-0031
(618) 826-4571
(618) 826-3229
Mailing address
12831 HICKORY WOODS DR, SAINT LOUIS, MO 63131-1828
(314) 966-8746
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
10/10/2005
Last updated
07/08/2007
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