Provider Demographics
NPI:1033563820
Name:JHA, PRAMEETA
Entity Type:Individual
Prefix:DR
First Name:PRAMEETA
Middle Name:
Last Name:JHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 N EDWARD STREET
Mailing Address - Street 2:DECATUR MEMORIAL HOSPITAL
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-0000
Mailing Address - Country:US
Mailing Address - Phone:217-876-3662
Mailing Address - Fax:
Practice Address - Street 1:2300 N EDWARD ST STE 3200
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4192
Practice Address - Country:US
Practice Address - Phone:217-876-3660
Practice Address - Fax:217-876-3665
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036149127207RP1001X, 207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine