Chandupatla Probhakar Md | |
559 N Westgate Jacksonville IL 62650 | |
(217) 243-5474 | |
(217) 245-2322 |
Full Name | Chandupatla Probhakar Md |
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Speciality | Internal Medicine |
Location | 559 N Westgate, Jacksonville, Illinois |
Authorized Official Name and Position | Chandupatla Prabhakar (OWNER PHYSICIAN) |
Authorized Official Contact | 2172435474 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chandupatla Probhakar Md 559 N Westgate Jacksonville IL 62650 Ph: (217) 243-5474 | Chandupatla Probhakar Md 559 N Westgate Jacksonville IL 62650 Ph: (217) 243-5474 |
NPI Number | 1558473405 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1558473405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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Jacksonville Family Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1602 W Lafayette Ave, Jacksonville, IL 62650 Phone: 217-243-7200 Fax: 217-243-6165 | |
Memorial Physician Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 W Walnut St, East Wing, 3rd Floor, Jacksonville, IL 62650 Phone: 217-245-5437 Fax: 217-243-3113 |