Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Pavana Sreenivasan, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1669905113

Dr. Pavana Sreenivasan, MD is a Student in an Organized Health Care Education/Training Program in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2017.

Licensed in
IL
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 624-0716
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Critical Care Medicine Physician (primary) Taxonomy 2080P0203X · Licence 036.164817 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1669905113
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 11, 2017
Last updated in NPPESSeptember 13, 2023
Certification dateSeptember 12, 2023
Mailing address1201 W La Veta Ave, Orange, CA 92868-4203

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