Individual
SONAL A SANGHVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
350 JOHN DEERE RD, MOLINE, IL 61265-6899
(309) 743-6700
(309) 743-6709
Mailing address
1236 E RUSHOLME ST, SUITE 300, DAVENPORT, IA 52803-2434
(563) 324-2992
(563) 888-0499
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001859
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001859
PA LICENSE NUMBER
IA
01
—
0080200
MEDICAID GROUP
IA
01
—
13238
MEDICARE PART B GROUP
IA
01
—
16-1801
MEDICARE NGS GROUP
IA
01
—
16D0387805
CLIA RIVER DRIVE
IA
01
—
42106072402
MEDICARE GROUP
IL
01
—
5101108
CSC RIVER DRIVE
IA
01
—
8122859
BCBS GROUP
IL
01
—
CP8565
RR MEDICARE GROUP
—
Enumeration date
11/01/2007
Last updated
08/18/2023
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