Individual
DR. SHRUTI JAGANNATH PATIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62702-3757
(217) 545-0182
(217) 545-4735
Mailing address
PO BOX 19636, SPRINGFIELD, IL 62794-9636
(217) 545-0182
(217) 545-4735
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036146897
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036146897
IL
207R00000X
Internal Medicine Physician
125063259
IL
Other
Enumeration date
06/25/2013
Last updated
03/30/2021
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