| Drs. Srivastava S.c. | |
|
5668 E State St Suite 2700 Rockford IL 61108-2490 | |
| (815) 226-1906 | |
| Not Available |
| Full Name | Drs. Srivastava S.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5668 E State St, Rockford, Illinois |
| Authorized Official Name and Position | Robin Eckhardt (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8152261906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Drs. Srivastava S.c. 5668 E State St Suite 2700 Rockford IL 61108-2490 Ph: (815) 226-1906 | Drs. Srivastava S.c. 5668 E State St Suite 2700 Rockford IL 61108-2490 Ph: (815) 226-1906 |
| NPI Number | 1750434361 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0840394847 |
|---|---|
| Medicare Enrollment ID | O20070402000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750434361 | NPI | - | NPPES |
| 008839 | Other | IL | HEALTH ALLIANCE |
| 0010100569 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 36061106 (Illinois) | Primary |
| Provider Name | Madhav Srivastava |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770565905 PECOS PAC ID: 2860596863 Enrollment ID: I20070402000042 |
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