Basic Information
| Provider Information | |||||||||
| NPI: | 1033563820 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JHA | ||||||||
| FirstName: | PRAMEETA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 N EDWARD STREET | ||||||||
| Address2: | DECATUR MEMORIAL HOSPITAL | ||||||||
| City: | DECATUR | ||||||||
| State: | IL | ||||||||
| PostalCode: | 625260000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2178763662 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2300 N EDWARD ST STE 3200 | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | IL | ||||||||
| PostalCode: | 625264192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2178763660 | ||||||||
| FaxNumber: | 2178763665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2016 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036149127 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.