Individual
DR. LEELA DHANEKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5405 N KNOXVILLE AVE, PEORIA, IL 61614-5016
(309) 691-4410
Mailing address
5405 N KNOXVILLE AVE, PEORIA, IL 61614-5016
(309) 691-4410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036094358
IL
207RC0000X
Cardiovascular Disease Physician
036094358
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036094358
IL
2471C3401X
Computed Tomography Radiologic Technologist
036094358
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094358
—
IL
Enumeration date
07/04/2006
Last updated
02/26/2025
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