| Organization Name: | ILLIANA INTERNAL MEDICINE, L.L.C. |
| NPI Number: | 1003962549 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VUPPALA V REDDY (SENIOR PARTNER) |
| Mailing Address: | 1332 N 7th St Terre Haute |
| State: | IN US |
| Postal Code: | 478071004 |
| Phone Number: | 8124788888 |
| Fax Number: | 8124781114 |
| NPI Enumeration Date: | 01/26/2007 |
| NPI Last Update Date: | 09/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 0104962A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |