Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125050385 | IL |
N | 111NI0900X | Internist | 125050385 | IL |
Y | 207RI0011X | Interventional Cardiology | 036140765 | IL |
NPI | 1003086182 |
---|---|
Provider Name | Dr. Uday Bhaskar Kanakadandi |
First Address | Urbana, IL 61801-2500 |
Second Address | Urbana, IL 61801-2500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2008 |
Last Update Date | 25/07/2016 |