Individual
SRAVANTHI NAGAVALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1253 N ALPINE RD, ROCKFORD, IL 61107
(779) 696-9201
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
(779) 696-7342
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9407033
KS
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036-127591
IL
Other
Enumeration date
07/03/2008
Last updated
02/19/2021
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