Individual
KONSTANTIN I DENEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 N 9TH ST, SUITE 4W16, SPRINGFIELD, IL 62702-5303
(217) 545-8000
(217) 757-6654
Mailing address
PO BOX 19676, SPRINGFIELD, IL 62794-9676
(217) 545-8000
(217) 757-6654
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036110062
IL
208000000X
Pediatrics Physician
ME138814
FL
2080P0203X
Pediatric Critical Care Medicine Physician
036-110062
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110062
—
IL
05
—
102858600
—
FL
Enumeration date
11/17/2005
Last updated
07/11/2023
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