Swaminathan, Revathi
Swaminathan, Revathi is an individual health care provider with primary practice located at 221 Ne Glen Oak Ave , Peoria IL 61636-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Swaminathan, Revathi can be contacted via phone (309) 672-5700.Contact Information
Primary practice address
221 Ne Glen Oak Ave
Peoria IL 61636-0001
Phone: (309) 672-5700
Fax: (309) 671-2774
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 036062991 | Illinois |
Profile Details
| NPI number | 1841234929 |
|---|---|
| LBN Legal business name | Swaminathan, Revathi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Mar 8th, 2016 - about 9 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 | 1841234929 | NPPES |
| Other | RAILROAD MED PIN | P00310337 | |
| MEDICAID | 036062991 | P00310337 | |
| Other | 254642 | P00310337 | |
| Other | CM5868 | P00310337 |
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