Individual
HIMANSHU PATHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 E MASON ST, SUITE 4P57, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535
Mailing address
619 E MASON ST, SUITE 4P57, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036134886
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036134886
—
IL
01
—
35897
MAIMONIDES MEDICAL CENTER
—
01
—
P01361174
RAILROAD
IL
Enumeration date
02/11/2008
Last updated
12/06/2019
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