Provider Demographics
NPI:1942468145
Name:JEGANMOHAN, JANANDANA KALADHINI (MD)
Entity type:Individual
Prefix:DR
First Name:JANANDANA
Middle Name:KALADHINI
Last Name:JEGANMOHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JANANDANA
Other - Middle Name:KALADHINI
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1014 E PATTON DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-3757
Mailing Address - Country:US
Mailing Address - Phone:618-997-4856
Mailing Address - Fax:
Practice Address - Street 1:27025 W EAMES ST UNIT B
Practice Address - Street 2:
Practice Address - City:CHANNAHON
Practice Address - State:IL
Practice Address - Zip Code:60410-5620
Practice Address - Country:US
Practice Address - Phone:815-467-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036120200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine