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General NPI Number Information
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NPI Number | 1548452188
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Entity Type | Organization
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Legal Business Name | MADHAV T RATNAKAR, MD P C
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 103 S MAIN ST
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City | MONMOUTH
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State | IL
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Zip | 61462-1751
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Country | US
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Telephone | 309-734-7820
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Fax | 309-734-5299
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Provider Business Mailing Address
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Address Line | 103 S MAIN ST
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City | MONMOUTH
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State | IL
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Zip | 61462-1751
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Country | US
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Telephone | 309-734-7820
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Fax | 309-734-5299
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Authorized Official
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Title or Position | MD
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Name | DR. MADHAV T RATNAKAR
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Credential | MD
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Telephone | 309-734-7820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | IL
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