Yaganti, Srinivasarao C
Yaganti, Srinivasarao C 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 / Hospitalist is his primary health care specialty. Yaganti, Srinivasarao C 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-094107 | Illinois |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036-094107 | Illinois |
Profile Details
| NPI number | 1245252972 |
|---|---|
| LBN Legal business name | Yaganti, Srinivasarao C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Mar 31st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245252972 | NPPES |
| Illinois | MEDICAID | 036094107 | |
| Illinois | Other | 110132770 |
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