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Contact Information

PRAVEEN KANDULA, MD
751 N RUTLEDGE ST
STE 1100
SPRINGFIELD, IL62702-4909
 Phone: 217-545-0182
 Fax: 217-545-4735
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PRAVEEN KANDULA · (Male)

NPI # 1912982919
Status Active
Credentials MD
Entity Individual
Enumeration date 12/13/2005
Last updated 06/22/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-113938
  • IL Medicaid 036113938
Hospital affiliation(s)
  • NEWARK BETH ISRAEL MEDICAL CENTER - (Acute Care)
    201 LYONS AVE
    NEWARK, NJ 07112
  • SAINT BARNABAS MEDICAL CENTER - (Acute Care)
    94 OLD SHORT HILLS ROAD
    LIVINGSTON, NJ 07039
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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