Individual
ASHIMA DATEY CHAKRABARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
319 E MADISON ST FL 3, SPRINGFIELD, IL 62701-1035
(217) 545-8000
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(217) 545-2101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.153654
IL
2084P0800X
Psychiatry Physician
Primary
036.153654
IL
Other
Enumeration date
06/22/2017
Last updated
10/23/2023
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