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Individual

DR. ANEESHA J PENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
720 N BOND ST, SPRINGFIELD, IL 62702-4952
(217) 545-8000
(217) 545-6544
Mailing address
PO BOX 19662, SPRINGFIELD, IL 62794-9662

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
125.084204
IL
390200000X
Student in an Organized Health Care Education/Training Program
125.084204
IL

Other

Enumeration date
03/16/2023
Last updated
08/08/2024
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