Individual
DEEPAK TANEJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 MAIN ST, SUITE 200, PEORIA, IL 61606-1907
(309) 672-5682
(309) 672-3147
Mailing address
1001 MAIN ST STE 200, SUITE 200, PEORIA, IL 61606-2035
(309) 672-5682
(309) 672-3147
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-33300
KS
207R00000X
Internal Medicine Physician
2007028030
MO
208M00000X
Hospitalist Physician
04-33300
KS
208M00000X
Hospitalist Physician
Primary
2007028030
MO
Other
Enumeration date
06/05/2007
Last updated
02/25/2014
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