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General NPI Number Information
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NPI Number | 1255524419
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Entity Type | Individual
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Provider Name | NIKHIL REDDY KALVA M.D
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Gender | Male
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | OSF SAINT FRANCIS MEDICAL CENTER DEPARTMENT OF INTERNAL MEDICINE
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City | PEORIA
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State | IL
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Zip | 61637-0001
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Country | US
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Telephone | 309-655-6931
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Fax |
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Provider Business Mailing Address
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Address Line | 5105 N GLEN PARK PLACE RD
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City | PEORIA
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State | IL
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Zip | 61614-4675
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Country | US
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Telephone | 309-308-5900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036125322
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License Number State | IL
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