Individual
PRATIMA CHALASANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
509 W UNIVERSITY AVE, MILLS CANCER CENTER, URBANA, IL 61801-1645
(217) 383-6636
(217) 383-3466
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-130709
IL
207RH0003X
Hematology & Oncology Physician
Primary
036130709
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036130709
—
IL
Enumeration date
07/10/2009
Last updated
10/18/2016
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