Provider Demographics
NPI:1255520532
Name:VERMA, NEELAM (MD)
Entity type:Individual
Prefix:DR
First Name:NEELAM
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FOREST HILL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-0000
Mailing Address - Country:US
Mailing Address - Phone:630-272-4380
Mailing Address - Fax:
Practice Address - Street 1:1600 W WALNUT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-0000
Practice Address - Country:US
Practice Address - Phone:217-243-8455
Practice Address - Fax:217-243-7951
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301089971207VX0000X
IL036133992207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036133992Medicaid