Individual
HRISHIKESH GHANEKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2006002056
MO
207RN0300X
Nephrology Physician
Primary
036107763
IL
207RN0300X
Nephrology Physician
2006002056
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036107763
—
IL
05
—
0718445
—
IA
05
—
207286402
—
MO
01
—
MO412
TEXAS MEDICAL LICENSE
—
Enumeration date
02/09/2006
Last updated
07/27/2022
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