Poola, Venkateswara P

Poola, Venkateswara P is an individual health care provider with primary practice located at 315 W Carpenter St 1St Floor, Springfield IL 62702. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Poola, Venkateswara P can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
315 W Carpenter St 1St Floor Springfield IL 62702
Phone: (217) 545-8000
Fax: (217) 545-0952
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036-135600 Illinois
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 036-135600 Illinois

Profile Details

NPI number 1821248881
LBN Legal business name Poola, Venkateswara P
Credentials MBBS
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2008
Last updated Jun 27th, 2018 - about 6 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 1821248881 NPPES
Illinois MEDICAID 036135600

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