| Dr Babu Rao Eladasari, MD,FACP | |
|
559 N Westgate Ave, Jacksonville, IL 62650-1156 | |
| (217) 243-5474 | |
| (217) 245-2322 |
| Full Name | Dr Babu Rao Eladasari |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 559 N Westgate Ave, Jacksonville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356393300 | NPI | - | NPPES |
| 036091905 | Other | IL | PHYSICIANS LICENSE |
| 336053421 | Other | IL | CONTROLLED SUBSTANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036091905 (Illinois) | Primary |
| Entity Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396097960 PECOS PAC ID: 4486667888 Enrollment ID: O20130424001019 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Babu Rao Eladasari, MD,FACP 559 N Westgate Ave, Jacksonville, IL 62650-1156 Ph: (217) 243-5474 | Dr Babu Rao Eladasari, MD,FACP 559 N Westgate Ave, Jacksonville, IL 62650-1156 Ph: (217) 243-5474 |
Dr. Eli G Goodman, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1600 W Walnut St, Jacksonville, IL 62650 Phone: 217-479-5890 | |
Dr. Edwin Roy Mathews, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 15 Founders Ln Ste 100, Jacksonville, IL 62650 Phone: 217-243-0300 Fax: 217-245-6775 | |
Dr. Thomas Anthony Baker, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2268 E Morton Ave, Jacksonville, IL 62650 Phone: 217-245-1481 | |
Chandupatla Prabhakar, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 559 N Westgate, Jacksonville, IL 62650 Phone: 217-243-5474 Fax: 217-245-2322 | |
Anthony M Griffin, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 15 Founders Ln Ste 100, Jacksonville, IL 62650 Phone: 217-243-0300 Fax: 217-245-6775 | |
Dr. David D Coultas, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1606 W Lafayette Ave, Jacksonville, IL 62650 Phone: 217-245-1421 Fax: 217-243-1699 |