Srivastava, Madhav K
Srivastava, Madhav K is an sole proprietor health care provider with primary practice located at 4920 E State St , Rockford IL 61108-2272. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Srivastava, Madhav K can be contacted via phone (815) 226-1906.Contact Information
Primary practice address
4920 E State St
Rockford IL 61108-2272
Phone: (815) 226-1906
Fax: (815) 226-8474
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 36061106 | Illinois |
Profile Details
| NPI number | 1770565905 |
|---|---|
| LBN Legal business name | Srivastava, Madhav K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Sep 26th, 2011 - about 13 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 | 1770565905 | NPPES |
| Illinois | Other | 791133506 | RETIRED RAILROAD |
| Illinois | MEDICAID | 036061106 | RETIRED RAILROAD |
| Illinois | Other | 008839 | RETIRED RAILROAD |
| Illinois | Other | 0010100569 | RETIRED RAILROAD |
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