Individual provider Active NPI

Rama R. Dandamudi, M.D.

  • Surgery Physician
  • Elmhurst, IL
National Provider Identifier
1235352766
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
1200 S York Rd
Suite 4250
Elmhurst, IL 60126-5626
Phone
(630) 758-5759
Fax
(630) 758-8751
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X IL Primary

Addresses

Primary practice location

1200 S York Rd
Suite 4250
Elmhurst, IL 60126-5626

Mailing address

1200 S York Rd
Suite 4250
Elmhurst, IL 60126-5626
Phone (630) 758-5759

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036087478ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rama R Dandamudi MD SC Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235352766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S YORK RD",
            "address_2": "SUITE 4250",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-758-5759",
            "fax_number": "630-758-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK RD",
            "address_2": "SUITE 4250",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-758-5759",
            "fax_number": "630-758-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDAMUDI",
        "first_name": "RAMA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, 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.

Verify at the official NPI Registry.