Individual
DR. BENALI GIRISH DESHPANDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
420 NE GLEN OAK AVE, SUITE 201, PEORIA, IL 61603-3105
(888) 627-5673
(309) 683-5969
Mailing address
420 NE GLEN OAK AVE, SUITE 201, PEORIA, IL 61603-3105
(888) 627-5673
(309) 683-5969
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-112326
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
809840
MEDICARE GROUP #
IL
Enumeration date
10/15/2007
Last updated
05/12/2008
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