Individual
DR. SHYAM KIRAN GANDAM VENKATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-2604
(217) 528-7541
(217) 606-3057
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036143316
IL
Other
Enumeration date
07/03/2012
Last updated
07/14/2025
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