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Individual

DR. RANDY K SULAVER II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
302 W HAY ST STE 200, DECATUR, IL 62526-4171
(217) 545-8000
(217) 872-1958
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036143964
IL
208800000X
Urology Physician
125061943
IL

Other

Enumeration date
06/26/2012
Last updated
04/20/2023
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