Individual
VENKATESH ANJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
THREE SAINT ELIZABETH BLVD STE 2800, O FALLON, IL 62269-1282
(618) 233-6044
(618) 233-5195
Mailing address
THREE SAINT ELIZABETH BLVD STE 2800, O FALLON, IL 62269-1282
(618) 233-6044
(618) 233-5195
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036127142
IL
207RC0000X
Cardiovascular Disease Physician
MT202334
PA
207RI0011X
Interventional Cardiology Physician
Primary
036.127142
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036127142
BCBS
IL
05
—
036127142
—
IL
01
—
P01726711
RAILROAD
IL
Enumeration date
08/01/2008
Last updated
12/20/2021
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