Polasani, Venugopal

Polasani, Venugopal is an individual health care provider with primary practice located at 1400 W Park St , Urbana IL 61801-2334. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Polasani, Venugopal can be contacted via phone (217) 337-2000.

Contact Information

Primary practice address
1400 W Park St Urbana IL 61801-2334
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X Illinois

Profile Details

NPI number 1083786917
LBN Legal business name Polasani, Venugopal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Oct 18th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083786917 NPPES
Illinois Other P00051600 RR MEDICARE
Illinois MEDICAID 36056262 RR MEDICARE
Illinois Other 1032044 RR MEDICARE
Illinois Other DA5283 RR MEDICARE

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