Jasti, Sravan Kumar

Jasti, Sravan Kumar is an individual health care provider with primary practice located at 611 W. Park St. , Urbana IL 61801-2500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Jasti, Sravan Kumar can be contacted via phone (217) 383-3605.

Contact Information

Primary practice address
611 W. Park St. Urbana IL 61801-2500
Phone: (217) 383-3605
Fax: (217) 383-2704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD449196 Pennsylvania
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 036138614 Illinois

Profile Details

NPI number 1760828842
LBN Legal business name Jasti, Sravan Kumar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2013
Last updated Oct 6th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1760828842 NPPES
Pennsylvania MEDICAID 102855372

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