Individual
DR. MUTHIAH THANGAVELU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
707 N LOGAN AVE, DANVILLE, IL 61832-4360
(217) 446-6410
(217) 477-4757
Mailing address
707 N LOGAN AVE, DANVILLE, IL 61832-4360
(217) 446-6410
(217) 477-4757
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036044903
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036044903
—
IL
05
—
100014790A
—
IN
01
—
177404
PERSONAL CARE/COVENTRY
—
01
—
247893
UNITED HEALTHCARE
—
Enumeration date
06/02/2006
Last updated
12/03/2009
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