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

Prudvi Tarun Betha, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558203760

Prudvi Tarun Betha, MD is a Student in an Organized Health Care Education/Training Program in Peoria, Illinois. Registered with an NPI since 2026.

In the registry since
2026
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
Phone: (309) 655-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1558203760
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 7, 2026
Last updated in NPPESApril 7, 2026
Mailing addressOne Illini Drive, Uicomp, Gme, Peoria, IL 61605

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