Dheeraj Davis Kalluri

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.010417 Issued in IL

Practice address

1757 Northwind Blvd
Libertyville, IL 60048-9617

Phone

(224) 206-0200

Fax

(224) 206-0201

NPI assigned

Jul 9, 2025

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1205727252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 NORTHWIND BLVD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489617",
            "telephone_number": "224-206-0200",
            "fax_number": "224-206-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLURI",
        "first_name": "DHEERAJ DAVIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.010417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JP Lehman, DDS., PC
• Timothy E. Kabot, D.D.S.
• Jacob Richard Kachelmeier, PHARMD
• Amberika Kahlon
• Seanra J Kalil, PA-C
• Kimberly Kamman, PT, DPT
• Patricia Ann Kampmeier, M.D.
• Meriam Kanikunnel, PA-C
• Karen J Counseling, LLC
• Karen Woodnorth, P.C.

• Physical Therapy Assistant in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.