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Individual

DR. SANJAY K GARG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.B.B.S

Contact information

Practice address
116 W BUCHANAN AVE, CHARLESTON, IL 61920-2522
(217) 345-7700
(217) 345-7200
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
(217) 868-2812

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01058382A
IN
208000000X
Pediatrics Physician
Primary
036095041
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200465180
IN
Enumeration date
07/21/2006
Last updated
07/06/2023
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