Individual
DR. SUDHA G PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.C.S.
Contact information
Practice address
901 S KOKE MILL RD, SPRINGFIELD, IL 62711-8012
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036079578
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028472
HEALTH ALLIANCE
IL
01
—
08405282
BCBS
IL
01
—
131837
HEALTHLINK
IL
01
—
D10632
UPIN
IL
Enumeration date
04/02/2008
Last updated
05/20/2020
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