Individual
DR. VIDHYA PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
751 N RUTLEDGE ST, SUITE 1100, SPRINGFIELD, IL 62702-4968
(217) 545-8000
(217) 788-5504
Mailing address
PO BOX 19648, SPRINGFIELD, IL 62794-9648
(217) 545-8000
(217) 788-5504
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036-134816
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036134816
—
IL
Enumeration date
04/19/2007
Last updated
12/09/2020
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