| Chandupatla Probhakar MD | |
|
559 N Westgate Jacksonville IL 62650 | |
| (217) 243-5474 | |
| (217) 245-2322 |
| Full Name | Chandupatla Probhakar MD |
|---|---|
| Speciality | Internal Medicine |
| Location | 559 N Westgate, Jacksonville, Illinois |
| Authorized Official Name and Position | Chandupatla Prabhakar (OWNER PHYSICIAN) |
| Authorized Official Contact | 2172435474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chandupatla Probhakar MD 559 N Westgate Jacksonville IL 62650 Ph: (217) 243-5474 | Chandupatla Probhakar MD 559 N Westgate Jacksonville IL 62650 Ph: (217) 243-5474 |
| NPI Number | 1558473405 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558473405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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