DR. SUJATHA KAILAS (NPI# 1861473936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861473936 |
| Entity Type | Individual |
| Full Name | DR. SUJATHA KAILAS |
| Credential | MD |
| Practice Address |
5744 N Broadway St Chicago IL 60660-4302 |
| Practice Telephone | 3123350180 |
| Practice Fax Number | 7732754679 |
| Mailing Telephone | 3123350180 |
| Mailing Fax Number | 7732754679 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2018-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036.134009 | IL | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
30129 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | RAILROAD MEDICARE | 110114149 | 01 |
| WI | 31576500 | 05 | |
| IL | MEDICARE | F400429459 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 420 E Division St, Fond Du Lac, WI 549354560 | 9209268570 |
| Street Address |
5744 N BROADWAY ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60660-4302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487126256 | Angela Louise Gregor | Internal Medicine | 5744 N Broadway St, Chicago, IL 60660-4302 | 2018-12-18 |
| 1194155283 | Stephanie Laser | Physician Assistant | 5744 N Broadway St, Chicago, IL 60660-4302 | 2013-11-26 |
| 1003124280 | Melissa Andrea Martinez Mateo | Internal Medicine | 5744 N Broadway St, Chicago, IL 60660-4302 | 2010-09-21 |
| 1114163979 | Zeid Faeq Karadsheh | Internal Medicine | 5744 N Broadway St, Chicago, IL 60660-4302 | 2008-12-29 |
| 1356526255 | Joseph D. Reses | Anesthesiology | 5744 N Broadway St, Chicago, IL 60660-4302 | 2008-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225672280 | Alexis Shelton | Behavior Technician | 6317 N Broadway, Chicago, IL 60660 | 2019-11-03 |
| 1912470105 | Pipeline - Lakefront Medical Associates, LLC | Family Medicine | 6201 North Broadway, Chicago, IL 60660 | 2019-01-10 |
| 1417492224 | Aynur Fataliyeva | Non-emergency Medical Transport (VAN) | 5701 N Sheridan Road, Apt 20g, Chicago, IL 60660 | 2017-01-03 |
| 1285187591 | Bryan Moles | Developmental Therapist | 6157 N Kenmore, Apt #4s, Chicago, IL 60660 | 2016-08-03 |
| 1144609181 | Ebm Consulting LLC | Anesthesiology | 5600 N Sheridan Road, #115, Chicago, IL 60660 | 2015-05-22 |
| 1295134112 | Brent E Agran, Dds, LLC | Dentist | 5820 N. Clark St., 1s, Chicago, IL 60660 | 2014-08-15 |
| 1538573258 | Emily Eaton | Student in an Organized Health Care Education/Training Program | 5643 N. Magnolia Ave, Chicago, IL 60660 | 2014-06-20 |
| 1538572664 | Rozina Altaf Virani | Nurse Practitioner | 6033 N Sheridan Rd Ste N6, Chicago, IL 60660 | 2014-06-05 |
| 1548673866 | Emily Mckernan | Social Worker | 5710 N Broadway Ave, Chicago, IL 60660 | 2014-06-04 |
| 1679902324 | Christopher Burgess | Psychologist | 1554 W Hollywood, #storefront, Chicago, IL 60660 | 2013-11-04 |
| Find all providers in zip 60660 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1104303296 | Amanda Israel | Internal Medicine | 5841 S Maryland Ave # 4076m410, Chicago, IL 60637-1443 | 2018-07-23 |
| 1447765888 | David Henoch Barch | Internal Medicine | 3431 N Leavitt St, Chicago, IL 60618-6013 | 2017-12-07 |
| 1205218658 | Ye Eun Kwak | Internal Medicine | 5841 S Maryland Ave Rm J-517, Chicago, IL 60637 | 2015-06-22 |
| 1154749042 | Joshua Michael Steinberg | Internal Medicine | 5841 S Maryland Ave # 4076, Chicago, IL 60637-1443 | 2014-03-28 |
| 1447599311 | Seymour Marshall Sabesin | Internal Medicine | 630 S Hermitage Ave, Suite 802, Chicago, IL 60612-3874 | 2013-02-12 |
| 1265796429 | Jonathan Mark Erlich | Internal Medicine | 7447 W Talcott Ave Ste 209, Chicago, IL 60631-3713 | 2012-07-02 |
| 1255628921 | Michael O Blackstone | Internal Medicine | 4103 N Harding Ave, Chicago, IL 60618-1913 | 2011-07-01 |
| 1346533213 | Amanda Guentner | Internal Medicine | 259 E Erie St Ste 2250, Chicago, IL 60611-3264 | 2011-05-25 |
| 1962795450 | Christine Chan | Internal Medicine | 429 W Melrose St, Apt. 2e, Chicago, IL 60657-3878 | 2011-05-17 |
| 1295039865 | Cemal Yazici | Internal Medicine | 840 S Wood Street Suite 718e, Chicago, IL 60612 | 2010-12-22 |
| Find all providers in CHICAGO | ||||
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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.