Individual
DR. BABU RAO ELADASARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,FACP
Contact information
Practice address
559 N WESTGATE AVE, JACKSONVILLE, IL 62650-1156
(217) 243-5474
(217) 245-2322
Mailing address
559 N WESTGATE AVE, JACKSONVILLE, IL 62650-1156
(217) 243-5474
(217) 245-2322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036091905
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036091905
PHYSICIANS LICENSE
IL
01
—
336053421
CONTROLLED SUBSTANCE
IL
Enumeration date
05/17/2006
Last updated
10/07/2016
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