Individual
DR. RAVISHANKAR HASANADKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-4049
(217) 238-4491
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
36123015
IL
2086S0129X
Vascular Surgery Physician
MD154236
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123015
—
IL
05
—
500636610
—
OR
Enumeration date
10/21/2006
Last updated
03/25/2026
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