LAVANYA BODDU

MATTOON, IL
NPI1851503833
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036121313)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: IL  036-121313)
Enumeration Date2007-05-04
Last Update Date2020-12-30
Business Address
LAVANYA BODDU MD
2512 HURST DR STE 120
MATTOON, IL 61938-9200
Phone number: 217-258-7590
Mailing Address
LAVANYA BODDU MD
611 W PARK ST FAPC
URBANA, IL 61801
Phone number: 217-789-1403