Individual
KAVITHA SUBRAMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
(815) 484-7001
Mailing address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
(815) 484-7001
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
36117270
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117270
—
IL
Enumeration date
04/04/2007
Last updated
09/15/2009
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