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).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
11310 N Oak Trail Dr, Peoria, IL 616151082 | (508) 963-8351 |
Street Address |
5401 N KNOXVILLE AVE STE 412B |
City | PEORIA |
State | IL |
Zip Code | 61614-5082 |
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 |
Find all providers in zip 61614 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
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. |
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 |
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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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.