Organization
SUDHA PRASAD M.D.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDHA G PRASAD M.D. (DOCTOR)
(217) 546-4868
Entity
Organization
Contact information
Practice address
901 S KOKE MILL RD, SPRINGFIELD, IL 62711-8012
(214) 546-4868
(217) 698-9286
Mailing address
901 S KOKE MILL RD, SPRINGFIELD, IL 62711-8012
(217) 546-4868
(217) 698-9286
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028472
HEALTH ALLIANCE
IL
01
—
08405082
BLUECROSS BLUESHIELD
IL
01
—
114404
GHP
IL
01
—
131837
HEALTHLINK
IL
Enumeration date
05/28/2006
Last updated
04/20/2008
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