Individual
PRERNA KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-7106
(309) 624-4945
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
DR.0053713
CO
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
036146970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036146970
—
IL
Enumeration date
04/11/2011
Last updated
01/31/2020
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