SURESH KRISHNAMOORTHY MD SC (NPI# 1912101163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912101163 |
| Entity Type | Organization |
| Organization Name | SURESH KRISHNAMOORTHY MD SC |
| Practice Address |
1054 M L King Dr Suite 126 Centralia IL 62801-3000 |
| Practice Telephone | 6185335500 |
| Practice Fax Number | 6185335501 |
| Mailing Telephone | 6185335500 |
| Mailing Fax Number | 6185335501 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SURESH KRISHNAMOORTHY (PHYSICIAN) |
| Authorized Official Telephone | 6185335500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
1054 M L KING DR SUITE 126 |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760440580 | Suresh Krishnamoorthy | Internal Medicine | 1054 M L King Dr, Suite 126, Centralia, IL 62801-3000 | 2006-05-02 |
| 1346251071 | Stephen T Ang | Internal Medicine | 1054 M L King Dr, Suite 120, Centralia, IL 62801-3000 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1760440580 | Suresh Krishnamoorthy | Internal Medicine | 1054 M L King Dr, Suite 126, Centralia, IL 62801-3000 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477058378 | Ranim Mira | Internal Medicine | 4021 W Belle Plaine Ave # Ge, Chicago, IL 60641-2412 | 2018-03-24 |
| 1518351758 | Vania Leung | Internal Medicine | 2600 S Michigan Ave Ste 205, Chicago, IL 60616-2857 | 2015-03-25 |
| 1699174540 | Hatem Hassaballa | Internal Medicine | 840 S Wood St Fl 4, Suite 409 (m/c 717), Chicago, IL 60612-4325 | 2014-08-16 |
| 1528495470 | Home Care Doctors of Illinois Inc | Internal Medicine | 121 Fairfield Way Ste 312, Bloomingdale, IL 60108-1585 | 2013-10-08 |
| 1699059857 | We Care for Seniors Ltd | Internal Medicine | 501 Ashbury Ct, Lemont, IL 60439-8422 | 2011-10-06 |
| 1508181108 | Francina Miguelina Peralta Machado | Internal Medicine | 3046 127th St, Blue Island, IL 60406-1827 | 2010-04-07 |
| 1295976892 | Woodridgeclinic-lemont | Internal Medicine | 15884 W 127th St, Suite H, Lemont, IL 60439-7422 | 2009-03-12 |
| 1609037498 | Katya Yanira Cruz Madrid | Internal Medicine | 840 S. Wood St, Mic 717 Suite 409, Chicago, IL 60612 | 2008-06-24 |
| 1326209446 | Downers Grove Geriatrics, LLC | Internal Medicine | 3800 Highland Ave Ste 111, Downers Grove, IL 60515-1558 | 2008-06-20 |
| 1801060538 | Ronald James Grason | Internal Medicine | 357 W Decatur St, Decatur, IL 62522 | 2008-04-14 |
| Find all providers with the same taxonomy | ||||
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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.