Individual
DR. KOMAL MANOJ RAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637
(309) 655-2274
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(847) 828-3232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036161312
IL
208000000X
Pediatrics Physician
036161312
IL
Other
Enumeration date
05/31/2018
Last updated
10/08/2024
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