Individual
JAYALAKSHMI ATTALURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
765 N KELLOGG ST, SUITE 205, GALESBURG, IL 61401-2875
(309) 345-0394
(309) 345-0130
Mailing address
765 N KELLOGG ST, SUITE 205, GALESBURG, IL 61401-2875
(309) 345-0394
(309) 345-0130
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036074153
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035977
HEALTH ALLIANCE
IL
05
—
0360741531
—
IL
01
—
260044754
MEDICARE RAILROAD
IL
01
—
472292
HEALTHLINK
IL
01
—
7215059
BCBS PPO
IL
Enumeration date
07/22/2006
Last updated
12/18/2012
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