Dr. Javier Andres Tellagorry
Vascular Surgeon
3331 W Deyoung St Suite 100
Marion
, Illinois 62959-5896
Dr. Javier Andres Tellagorry
Vascular Surgeon
3331 W Deyoung St Suite 100
Marion
, Illinois 62959-5896
(618) 997-6680
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Javier Andres Tellagorry
- 3331 W Deyoung St Suite 100
- Marion, IL
- Zip : 62959-5896
- Fax : (618) 997-6680
- Phone : (618) 998-7600
Second Address
- Dr. Javier Andres Tellagorry
- 3331 W Deyoung St Suite 100
- Marion, IL
- Zip : 62959-5896
- Fax : (618) 997-6680
- Phone : (618) 998-7600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | 036141173 | IL |
National Provider Identifier
| NPI | 1053544627 |
|---|---|
| Provider Name | Dr. Javier Andres Tellagorry |
| First Address | Marion, IL 62959-5896 |
| Second Address | Marion, IL 62959-5896 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/08/2009 |
| Last Update Date | 17/10/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.