| Vsr Pllc | |
|
180 W Imboden Dr Decatur IL 62521-5238 | |
| (715) 207-1134 | |
| Not Available |
| Full Name | Vsr Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 180 W Imboden Dr, Decatur, Illinois |
| Authorized Official Name and Position | Venu M Rangu (PRESIDENT) |
| Authorized Official Contact | 7153879055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vsr Pllc 4200 Conestoga Dr Ste 102 Po Box 178 Springfield IL 62711-7937 Ph: (715) 207-1134 | Vsr Pllc 180 W Imboden Dr Decatur IL 62521-5238 Ph: (715) 207-1134 |
| NPI Number | 1104510650 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 06/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104510650 | NPI | - | NPPES |
| F100973628 | Other | IL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
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