Individual
VIKRAM AGRAWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 JOHN DEERE RD, SUITE 308, MOLINE, IL 61265-6869
(309) 779-7900
(309) 779-7905
Mailing address
600 JOHN DEERE RD, SUITE 308, MOLINE, IL 61265-6869
(309) 779-7900
(309) 779-7905
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036123868
IL
208000000X
Pediatrics Physician
MD-41434
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123868
—
IL
Enumeration date
07/06/2009
Last updated
07/01/2015
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