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1902549439
VIKAS MANJUNATH
PEORIA, IL
NPI
1902549439
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL 390200000x)
Enumeration Date
2022-04-13
Last Update Date
2022-04-13
Business Address
VIKAS MANJUNATH MD
900 MAIN ST STE 720
PEORIA, IL 61602-5027
Phone number: 309-495-1640
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Mailing Address
VIKAS MANJUNATH MD
224 WESTFIELD WAY
BARRINGTON, IL 60010-9335
Phone number: 847-346-5492
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