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Contact Information

CHAMPA GOWDA, MD
2709 N KNOXVILLE AVE
PEORIA, IL61604-2867
 Phone: 309-688-2117
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CHAMPA GOWDA · (Female)

NPI Number 1295749885
Status Active
Credentials MD
Entity Individual
Enumeration date 07/28/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • IL Medicaid 0361089691
  • IL Other 7215059 BCBS PPO
  • IL Other 090147 HEALTH ALLIANCE
  • IL Other 472011 HEALTHLINK
  • IL Other IL01L1 JOHN DEERE
  • IL Other P00144764 RAILROAD MEDICARE
Hospital affiliation(s)
  • MEDICAL CITY DALLAS HOSPITAL - (Acute Care)
    7777 FOREST LANE
    DALLAS, TX 75230
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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