Provider Demographics
NPI:1114974441
Name:SEKAR, VENKAT E (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKAT
Middle Name:E
Last Name:SEKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N LOGAN AVE
Mailing Address - Street 2:DANVILLE POLYCLINIC, LTD.
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4360
Mailing Address - Country:US
Mailing Address - Phone:217-477-4772
Mailing Address - Fax:217-477-4704
Practice Address - Street 1:707 N LOGAN AVE
Practice Address - Street 2:DANVILLE POLYCLINIC, LTD.
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4360
Practice Address - Country:US
Practice Address - Phone:217-477-4772
Practice Address - Fax:217-477-4704
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036073793207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
170578OtherPERSONAL CARE/COVENTRY
239858OtherUNITED HEALTHCARE
IL036073793Medicaid
IN100014770AMedicaid
IN100014770AMedicaid
239858OtherUNITED HEALTHCARE
C37054Medicare UPIN
IL036073793Medicaid