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Individual

DR. SAJJAN K NEMANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6828 STATE ROUTE 162 STE 2, MARYVILLE, IL 62062-8558
(618) 288-5906
(618) 288-5914
Mailing address
6810 STATE ROUTE 162, BOX 215, MARYVILLE, IL 62062
(618) 391-6495

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036078556
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036078556
IL
01
051812
HEALTH ALLIANCE
IL
01
06123524
BLUE CROSS BLUE SHIELD
IL
01
111163
HEALTHLINK
IL
01
CI3449
RAILROAD MEDICARE
IL
Enumeration date
05/11/2006
Last updated
08/28/2024
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