SASIKANTH GORANTLA (NPI# 1235426487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235426487 |
| Entity Type | Individual |
| Full Name | SASIKANTH GORANTLA |
| Credential | MD |
| Practice Address |
3315 N Seminary St Galesburg IL 61401-1251 |
| Practice Telephone | 3093441000 |
| Practice Fax Number | 3093442405 |
| Mailing Telephone | 3093441000 |
| Mailing Fax Number | 3093442405 |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2016-09-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036.138858 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
3315 N SEMINARY ST |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401-1251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487696126 | Noor A Khaiser | Internal Medicine | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2006-06-10 |
| 1669022752 | Angela M Bickett | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-09-19 |
| 1902455140 | Bailey Jean Bucher | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-09-10 |
| 1417509407 | Tara Lynn Livingston | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-07-10 |
| 1164984225 | Julie Anne Maner-stevenson | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-04-05 |
| 1629573878 | Brittany S Simmons | Physician Assistant | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2018-03-29 |
| 1508360066 | Angela B Klapp | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2018-03-20 |
| 1962831511 | Amanda Ryan | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2013-11-04 |
| 1922436682 | Jackie Spence | Physician Assistant | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2013-10-16 |
| 1003164617 | Melissa Hajostek | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2012-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1063814309 | Lakshmi Kalyani Gudavalli | Physical Therapist | 275 E Carl Sandburg Drive, Marigold Rehabilitation, Galesburg, IL 61401 | 2014-09-18 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| Find all providers in zip 61401 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477562866 | Denise M Johnson-dechow | Psychiatry & Neurology | 765 N Kellogg St, Suite 205, Galesburg, IL 61401-2875 | 2006-08-05 |
| 1447266564 | Marc Katchen | Psychiatry & Neurology | 765 N Kellogg St, Suite 207, Galesburg, IL 61401-2875 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831714294 | Kaitlin E Keenan | Psychiatry & Neurology | 600 S Paulina St Ste 403aac, Chicago, IL 60612-3806 | 2020-06-11 |
| 1811546484 | Glencor Neuromonitoring LLC | Psychiatry & Neurology | 611 S Milwaukee Ave Ste 8, Libertyville, IL 60048-3256 | 2019-09-06 |
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1972167906 | Kazkaz Southwest Neurology S.c. | Psychiatry & Neurology | 1890 Silver Cross Blvd Ste 320, New Lenox, IL 60451-9610 | 2019-04-25 |
| 1285195594 | Niccolo Emanuele Mencacci | Psychiatry & Neurology | 303 E Chicago Ave # 12-226, Chicago, IL 60611-4296 | 2019-03-28 |
| 1497216865 | Juan Pablo Ospina Botero | Psychiatry & Neurology | 5841 S Maryland Ave # 2030s231, Chicago, IL 60637-1443 | 2019-03-28 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1124526272 | Neurology Clinic of Chicago, LLC | Psychiatry & Neurology | 4909 W Division St Ste 302, Chicago, IL 60651-3161 | 2018-01-23 |
| 1538514120 | Kathleen Mary Gorman | Psychiatry & Neurology | 225 E Chicago Avenue, Chicago, IL 60611 | 2016-05-02 |
| 1396190203 | Lauren Brandes | Psychiatry & Neurology | 1725 W Harrison St Ste 309, Chicago, IL 60612-3844 | 2016-04-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.