Individual
MANOJ SREEDHARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 398-9491
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD-45204
IA
2083X0100X
Occupational Medicine Physician
Primary
036139330
IL
Other
Enumeration date
07/08/2013
Last updated
01/03/2024
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