Saravanan, Pathanjali

Saravanan, Pathanjali is an individual health care provider with primary practice located at 4500 Memorial Dr , Belleville IL 62226-5360. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Saravanan, Pathanjali can be contacted via phone (618) 257-6220.

Contact Information

Primary practice address
4500 Memorial Dr Belleville IL 62226-5360
Phone: (618) 257-6220
Fax: (618) 257-6679
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036091243 Illinois
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 036091243 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036091243 Indiana

Profile Details

NPI number 1639284862
LBN Legal business name Saravanan, Pathanjali
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Feb 4th, 2021 - about 3 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 1639284862 NPPES
Illinois MEDICAID 394790

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