Individual
SREEJITH MOHAN VELLIYATTIKUZHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-4756
(217) 544-6464
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036148170
IL
390200000X
Student in an Organized Health Care Education/Training Program
MT210326
PA
Other
Enumeration date
07/08/2013
Last updated
09/11/2024
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