Deotale, Pravesh P
Deotale, Pravesh P is an individual health care provider with primary practice located at 5220 S 6Th Street Rd 1200 Suite, Springfield IL 62703-5735. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Deotale, Pravesh P can be contacted via phone (217) 545-7644.Contact Information
Primary practice address
5220 S 6Th Street Rd 1200 Suite
Springfield IL 62703-5735
Phone: (217) 545-7644
Fax: (217) 585-6890
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 125059332 | Illinois |
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 036135582 | Illinois |
Profile Details
NPI number | 1710275110 |
---|---|
LBN Legal business name | Deotale, Pravesh P |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 19th, 2011 |
Last updated | Jun 2nd, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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