Organization
EFFINGHAM UROLOGY ASSOCIATES,S.C.
Active
Organization
EFFINGHAM UROLOGY ASSOCIATES,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PERNANKEL D L NAYAK M.D. (OWNER)
(217) 342-9738
Entity
Organization
Contact information
Practice address
414 W VIRGINIA AVE, EFFINGHAM, IL 62401-2258
(217) 342-9738
(217) 342-9806
Mailing address
414 W VIRGINIA AVE, P O BOX 1169, EFFINGHAM, IL 62401-2258
(217) 342-9738
(217) 342-9806
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
042003881
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002500053
BCBS
IL
01
—
CC9824
RAILROAD MEDICARE
IL
Enumeration date
08/21/2006
Last updated
05/19/2008
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