Individual
HARSHAVARDHAN REDDY GHADIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-9351
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-3140
(309) 655-7257
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125063220
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036139804
IL
Other
Enumeration date
08/31/2013
Last updated
06/24/2023
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