Organization Active NPI

Krishna Sunkara MD SC

  • Pulmonary Disease Physician
  • Hazel Crest, IL
National Provider Identifier
1194770586
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
57322217 Issued in IL
Legal business name
KRISHNA SUNKARA MD SC
Practice address
17680 Kedzie Ave
Suite 101
Hazel Crest, IL 60429-2043
Phone
(708) 799-7990
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Krishna Sunkara, MDNPI 1154328185
Title
Owner / Physician
Phone
(708) 799-7990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 57322217 IL Primary

Addresses

Primary practice location

17680 Kedzie Ave
Suite 101
Hazel Crest, IL 60429-2043

Mailing address

17680 Kedzie Ave
Suite 101
Hazel Crest, IL 60429-2043

Other identifiers 1

IdentifierTypeStateIssuer
0001627870OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426000967 IL Part B Supplier - Clinic/Group Practice 0547257354 Receives reassigned benefits from 1 practitioner
Practice locations: Country Club Hills, IL; Richton Park, IL; Oak Lawn, IL; Northlake, IL; Hazel Crest, IL; Evergreen Park, IL; Burbank, IL; Burnham, IL…

National Provider Directory

National Provider Directory

Locations

17680 Kedzie Ave
Ste 201
Hazel Crest, IL 60429
Phone (708) 799-2499

17680 Kedzie Ave
Ste 101
Hazel Crest, IL 60429
Phone (708) 798-8800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1194770586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17680 KEDZIE AVE",
            "address_2": "SUITE 101",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17680 KEDZIE AVE",
            "address_2": "SUITE 101",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292043",
            "telephone_number": "708-799-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISHNA SUNKARA MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "SUNKARA",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "708-799-7990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "57322217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001627870",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.