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Contact Information

LOKANATHAM GUMIDYALA
600 N COLLEGE AVE
GENESEO, IL61254-1091
 Phone: 309-944-6431
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Personal Emergency Response Attendant

146D00000X
Indicates primary specialty

NPI Profile & details for LOKANATHAM GUMIDYALA · (Male)

NPI # 1235244336
Status Active
Credentials
Entity Individual
Enumeration date 08/20/2006
Last updated 04/25/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 36063714
  • KY License # 45766
  • TX License # N2099
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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