ANDREW PAUL THALIATH

SPRINGFIELD, IL
NPI1881252013
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: IL  125073740)
Additional Taxonomies207R00000X Internal Medicine
(Licence: IL  125073740)
Enumeration Date2019-06-03
Last Update Date2019-09-20
Business Address
ANDREW PAUL THALIATH
751 N RUTLEDGE ST
SPRINGFIELD, IL 62702-4968
Phone number: 217-545-8000
Mailing Address
ANDREW PAUL THALIATH
PO BOX 19643
SPRINGFIELD, IL 62794-9643
Phone number: 217-545-8000