Keerthana Palaniappa Sivakolundu, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.079672 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637

Phone

(309) 655-2730

Fax

(309) 655-3297

NPI assigned

Apr 22, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1053055459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "OSF ST. FRANCIS MEDICAL CENTER, INTERNAL MEDICINE RESID",
            "address_2": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61637",
            "telephone_number": "309-655-2730",
            "fax_number": "309-655-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61637",
            "telephone_number": "309-655-2730",
            "fax_number": "309-655-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALANIAPPA SIVAKOLUNDU",
        "first_name": "KEERTHANA",
        "name_prefix": "Ms.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.079672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Michelle Owens-Spahn, LCPC
• Aaron M Owens, NP
• Anne Padwojski, APN
• Grace N Pagliaro, RBT
• Eunice Paik
• Nicholas Palcheff
• Vijayasree Paleru, M.D.
• Alexandra Joelle Palmer
• Daniel W Palmer Jr., MD
• Michael A Palmer, RPH

• Internal Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.