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Individual

JAYARAJ SALIMATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
900 MAIN ST, SUITE 530, PEORIA, IL 61602-1005
(309) 672-5975
(309) 655-1678
Mailing address
900 MAIN ST, SUITE 530, PEORIA, IL 61602-1005
(309) 672-5975
(309) 655-1678

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036117950
IL
208600000X
Surgery Physician
Primary
OS9781
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036117950
IL
Enumeration date
06/11/2006
Last updated
09/17/2012
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