SREENIVASA BASAVANTHAPPA

BLOOMINGTON, IL
NPI1497953871
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207WX0107X Ophthalmology, Retina Specialist
(Licence: IL  03-6163408)
Enumeration Date2007-07-06
Last Update Date2023-12-28
Business Address
Dr. SREENIVASA BASAVANTHAPPA MD
2501 E COLLEGE AVE STE B
BLOOMINGTON, IL 61704-2484
Phone number: 309-557-8666
Mailing Address
Dr. SREENIVASA BASAVANTHAPPA MD
1008 N MAIN ST
BLOOMINGTON, IL 61701-1784
Phone number: 309-557-8666
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