Chandupatla Probhakar MD

NPI #1558473405 in Jacksonville, Illinois

Provider Information

NPI Number: 1558473405
Entity Type: Organization
Organization Name: Chandupatla Probhakar MD
Primary Specialty: Internal Medicine
Enumeration Date: Aug 31, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 559 N WESTGATE
City: Jacksonville
State: Illinois
ZIP Code: 62650
Phone: (217) 243-5474

Authorized Official

Name: CHANDUPATLA PRABHAKAR, MD
Title: OWNER PHYSICIAN
Phone: (217) 243-5474

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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