PRAVEEN R. ANEGONDHI SUDHINDRA


Address: 5401 N Knoxville Ave Ste 412b, Peoria, IL 61614-5082
Phone: 3096896093

PRAVEEN R. ANEGONDHI SUDHINDRA (NPI# 1225340045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225340045
Entity Type Individual
Full Name PRAVEEN R. ANEGONDHI SUDHINDRA
Credential M.D.
Practice Address 5401 N Knoxville Ave Ste 412b
Peoria
IL 61614-5082
Practice Telephone 3096896093
Practice Fax Number 3095245599
Mailing Telephone 3096896093
Mailing Fax Number 3095245599
Enumeration Date 2010-07-09
Last Update Date 2018-09-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
036.142107 IL Allopathic & Osteopathic Physicians
N 207RI0200X Internal Medicine
Specialization: Infectious Disease
036.142107 IL Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
11310 N Oak Trail Dr, Peoria, IL 616151082 (508) 963-8351

Office Location

Street Address 5401 N KNOXVILLE AVE STE 412B
City PEORIA
State IL
Zip Code 61614-5082

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548818511 Christine Svoboda Social Worker 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 2019-09-03
1639649007 Kathy Karouzos Counseling, LLC Clinic/Center 330 W. Ivy Ln., Peoria, IL 61614 2018-11-28
1205312790 Kathleen Marie Hendricks Nurse Practitioner 2809 W Willow Knolls Dr, Peoria, IL 61614 2018-07-17
1629563937 Mary Elizabeth Cunningham Counselor 6219 N. Eldorado Dr., Peoria, IL 61614 2018-06-28
1861937955 Angela Gilles Social Worker 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 2016-12-27
1467994897 Melissa Saxsma Specialist 5009 N Executive Dr, Peoria, IL 61614 2016-11-16
1902258874 Rashid Plastic Surgery, LLC Plastic Surgery 804 W Trailcreek Drive, Peoria, IL 61614 2016-07-05
1215313143 Melissa Lynn Phelan Nurse Practitioner 122 E Morningside Dr, Peoria, IL 61614 2015-08-03
1811380165 All Ways Caring Services, Inc. In Home Supportive Care 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 2015-03-11
1568875920 Schuler & Arkwell Orthodontic Partnership Dentist 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 2014-06-03
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Taxonomy Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003809930 Robert R Orr Internal Medicine 9171 W Thunderbird Rd, Suite 101, Peoria, AZ 85381-4872 2005-08-25
1215153077 Aiyub Patel Internal Medicine 900 Main St, Suite 630, Peoria, IL 61602-1005 2007-04-18
1922013689 Walter Honorio Migotto Internal Medicine 9171 W Thunderbird Rd, Suite 101, Peoria, AZ 85381 2006-07-30
1831143585 Peoria Pulmonary Associates, Ltd. Internal Medicine 1001 Main St, Suite 200, Peoria, IL 61606-1907 2006-05-19
1932195880 Subramanyam Chittivelu Internal Medicine 1001 Main St, Suite 200, Peoria, IL 61606-1907 2005-09-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1861970626 Suburban Pulmonary & Critical Care Assoc, Inc Internal Medicine 3 Erie Ct Ste 7010, Oak Park, IL 60302-2519 2018-08-03
1265883441 Kunal H. Patel Internal Medicine 9600 Gross Point Rd. Im/icu Hospitalists, Skokie, IL 60076-1900 2016-06-28
1760896633 Zohaib Akhtar Internal Medicine 301 S Park Ave, Herrin, IL 62948-3603 2014-06-18
1699187344 Said Abuhasna Internal Medicine 800 Biesterfield Rd Ste 105, Elk Grove Village, IL 60007-3372 2014-05-29
1053678755 Nida Junaid Internal Medicine 305 W Jackson St Ste 301, Carbondale, IL 62901-1474 2012-04-18
1730446998 Steven Jay Quinn Internal Medicine 11900 Southwest Hwy Ste 101, Palos Park, IL 60464 2012-04-12
1588970933 Farbod Ghods Internal Medicine 5841 S Maryland Ave # Mc6026, Chicago, IL 60637-1447 2010-08-24
1588984454 James M Walter Internal Medicine 240 East Huron, Mcgaw M-300, Chicago, IL 60611 2010-06-02
1568789485 Suleman A Umar Internal Medicine 4440 W 95th St Rm 190s, Oak Lawn, IL 60453-2600 2010-05-03
1972829240 Devon Wayne Paul Internal Medicine 1414 S Fairfield Ave, Chicago, IL 60608 2010-04-12
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Competitor

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City PEORIA
Zip Code 61614

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Dataset Information

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.

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