Individual
DR. AVANI GANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.B.B.S
Contact information
Practice address
400 N 9TH ST FL 4, SPRINGFIELD, IL 62702-5310
(217) 545-8000
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
LP04881
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/26/2017
Last updated
06/13/2023
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