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1447452180
BHAVANA THOTA KANDIKATTU
PEORIA, IL
NPI
1447452180
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Former Name
BHAVANA THOTA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
208000000X Pediatrics
(Licence: IL 125050396)
Enumeration Date
2007-06-04
Last Update Date
2023-08-15
Business Address
Dr. BHAVANA THOTA KANDIKATTU MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-573-1167
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Mailing Address
Dr. BHAVANA THOTA KANDIKATTU MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-573-1167
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