Individual
DR. PAVANA SREENIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-0716
Mailing address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
036.164817
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2017
Last updated
09/13/2023
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