Sundareshan, Vidya

Sundareshan, Vidya is an individual health care provider with primary practice located at 751 N Rutledge St Suite 1100, Springfield IL 62702-4909. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is her primary health care specialty. Sundareshan, Vidya can be contacted via phone (217) 545-9537.

Contact Information

Primary practice address
751 N Rutledge St Suite 1100 Springfield IL 62702-4909
Phone: (217) 545-9537
Fax: (217) 545-8025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-121672 Illinois
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 036-121672 Illinois

Profile Details

NPI number 1376790733
LBN Legal business name Sundareshan, Vidya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2008
Last updated Jan 21st, 2010 - about 16 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 1376790733 NPPES
Illinois MEDICAID 036121672

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