Individual
GOUTAMI KANNA NALLAMOTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2603 S 6TH ST, SPRINGFIELD, IL 62703-3807
(217) 528-0307
Mailing address
PO BOX 4566, SPRINGFIELD, IL 62708-4566
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036096435
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036096435
ILLINOIS LICENSE
IL
Enumeration date
12/14/2009
Last updated
12/14/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us