Individual
DEEPTI SUDHAKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 S GRAND BLVD, SAINT LOUIS, MO 63104-1004
(309) 550-6802
Mailing address
2020 W MINERS DR, DUNLAP, IL 61525-9038
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MO
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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