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Individual

PRACHI JAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-1046
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036162447
IL
2085R0001X
Radiation Oncology Physician
153621
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
270369
MEDICAL LICENSE
NY
Enumeration date
06/14/2011
Last updated
02/06/2023
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