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Individual

SRAVAN K JASTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
611 W. PARK ST., URBANA, IL 61801-2500
(217) 383-3605
(217) 383-2704
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036138614
IL
207RN0300X
Nephrology Physician
Primary
036138614
IL
207RN0300X
Nephrology Physician
MD449196
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102855372
PA
Enumeration date
05/16/2013
Last updated
06/20/2025
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