PRAVESH P DEOTALE

SPRINGFIELD, IL
NPI1710275110
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
(Licence: IL  036135582)
Additional Taxonomies2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: IL  125059332)
Enumeration Date2011-07-19
Last Update Date2015-06-02
Business Address
Dr. PRAVESH P DEOTALE M.D
5220 S 6TH STREET RD 1200 SUITE
SPRINGFIELD, IL 62703-5735
Phone number: 217-545-7644
Mailing Address
Dr. PRAVESH P DEOTALE M.D
5220 S 6TH STREET RD 1200 SUITE
SPRINGFIELD, IL 62703-5735
Phone number: 217-545-7644