MEDICARE: RADHIKA DESHPANDE MBBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	35.155335	OH
2	207R00000X	Internal Medicine Physician	125.075627	IL

General Provider Information

NPI Number	:	1336761006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RADHIKA DESHPANDE MBBS

Provider Business Mailing Address
First Line	:	1B COUNTRY CLUB CT
Second Line	:
City	:	PEKIN
State	:	IL
Zip	:	61554-2608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 N 1ST ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62702-3757
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2020
Last Update Date	:	04/11/2026

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Directions to “ RADHIKA DESHPANDE MBBS” Practice Location

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