Active NPI
Rachana Sureka, MD
- Pediatrics Physician
- Peoria, IL
National Provider Identifier
1093721573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Practice address
- 7801 N Knoxville Ave
Peoria, IL 61614-2076 - Phone
- (309) 692-6088
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | IL | Primary |
Addresses
Primary practice location
7801 N Knoxville Ave
Peoria, IL 61614-2076
Mailing address
5100 Reliable Pkwy
Chicago, IL 60686-0001
Phone (309) 672-4809
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL01W6 | Other | IL | JOHN DEERE |
| 475091 | Other | IL | HEALTHLINK |
| 0361106872 | Medicaid | IL | |
| 7215059 | Other | IL | BCBS PPO |
| 094335 | Other | IL | HEALTH ALLIANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward M. Gotlieb, M.D., Et Al Dba the Pediatric Center | Pediatrics | Past | Accepting new patients |
| Childfren'S Medical Group, P.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
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- Atlanta, GA
- NPI 1497865935
-
- Pediatrics Physician
- Stone Mountain, GA
- NPI 1619197498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093721573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 RELIABLE PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606860001",
"telephone_number": "309-672-4809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7801 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616142076",
"telephone_number": "309-692-6088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUREKA",
"first_name": "RACHANA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "IL01W6",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "475091",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0361106872",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PPO",
"identifier": "7215059",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "094335",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.