Individual
GIRISH GANESH DESHPANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2250
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2250
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
036109253
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109253
—
IL
01
—
07215036
BCBS
IL
Enumeration date
11/15/2006
Last updated
10/03/2008
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