Individual
KANINIKA VERMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 MAIN ST, SUITE 200, PEORIA, IL 61606-1907
(309) 672-5682
(309) 672-3147
Mailing address
1001 MAIN ST, SUITE 200, PEORIA, IL 61606-1907
(309) 672-5682
(309) 672-3147
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036129385
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036129385
IL
207RP1001X
Pulmonary Disease Physician
Primary
036129385
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
036129385
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
11/10/2006
Last updated
02/10/2012
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