Organization
CHANDUPATLA PROBHAKAR MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDUPATLA PRABHAKAR MD (OWNER PHYSICIAN)
(217) 243-5474
Entity
Organization
Contact information
Practice address
559 N WESTGATE, JACKSONVILLE, IL 62650
(217) 243-5474
(217) 245-2322
Mailing address
559 N WESTGATE, JACKSONVILLE, IL 62650
(217) 243-5474
(217) 245-2322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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