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Individual

PRATAP ATTALURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3248 VANDEVER AVE, PEKIN, IL 61554
(309) 347-5522
(309) 347-7302
Mailing address
3248 VANDEVER AVE, PEKIN, IL 61554
(309) 347-5522
(309) 347-7302

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036084923
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00303608492301
CONTROLLED SUBSTANCE
IL
05
036084923
IL
Enumeration date
04/18/2006
Last updated
03/07/2023
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