Provider Demographics
NPI:1811322001
Name:KUMAR, SNEHA (MD)
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:KUMAR
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 1:304 W HAY ST STE 218
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4169
Mailing Address - Country:US
Mailing Address - Phone:217-876-6330
Mailing Address - Fax:217-876-6335
Practice Address - Street 1:302 W HAY ST
Practice Address - Street 2:SUITE 110
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4167
Practice Address - Country:US
Practice Address - Phone:217-876-6330
Practice Address - Fax:217-876-6335
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036139241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine