Kuganeswaran, Eliathamby
Kuganeswaran, Eliathamby is an individual health care provider with primary practice located at 1001 W Main St Suite 500A, Peoria IL 61606-1276. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Kuganeswaran, Eliathamby can be contacted via phone (309) 672-4980.Contact Information
Primary practice address
1001 W Main St Suite 500A
Peoria IL 61606-1276
Phone: (309) 672-4980
Fax: (309) 671-2944
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 036105345 | Illinois |
Profile Details
| NPI number | 1073555488 |
|---|---|
| LBN Legal business name | Kuganeswaran, Eliathamby |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2006 |
| Last updated | May 28th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073555488 | NPPES |
| Illinois | MEDICAID | 036105345 | |
| Illinois | Other | 100015542 | |
| Illinois | Other | 071696 | |
| Illinois | Other | 371221637 | |
| Illinois | Other | 658303 | |
| Illinois | Other | 07215152 | |
| Illinois | Other | 776530 | |
| Illinois | Other | 7991429 | |
| Illinois | Other | IL0117 |
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