Individual
DR. KRISHNA K R MANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6940 VILLAGREEN VW, ROCKFORD, IL 61107-5605
(779) 774-9272
(779) 774-9273
Mailing address
PO BOX 3877, JOLIET, IL 60434-3877
(815) 741-6830
(815) 741-6832
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036136899
IL
Other
Enumeration date
08/18/2009
Last updated
09/15/2022
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