Venkat Yashaswi Kondapalli

NPI 1740704832 · on the registry since 2017

Practice

Address: 1200 W Main St Ste 9
Peoria, IL 61606
Phone: (309) 777-9777
Organisation at this address: Highland Park Cvs, L.L.C.
Optim Dental Peoria-1 Llc
Access Dental Of Peoria Optim Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2017-07-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois