Individual
DR. RAJESH KANNAN ETHIRAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
927 BROADWAY ST, QUINCY, IL 62301-2719
(217) 223-6423
(217) 223-6407
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
U0017
TX
2083X0100X
Occupational Medicine Physician
Primary
036121632
IL
2083X0100X
Occupational Medicine Physician
56255
WI
Other
Enumeration date
09/07/2007
Last updated
07/03/2024
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