Active NPI
Sujiththa Suntharalingam, M.D.
- Family Medicine Physician
- Decatur, IL
National Provider Identifier
1245614338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 125-066296
- Practice address
- 250 W Kenwood Ave
Decatur, IL 62526-4371 - Phone
- (217) 872-3800
- Fax
- (217) 872-0849
- NPI assigned
- Jul 17, 2015
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125-066296 | IL | Primary |
Addresses
Primary practice location
250 W Kenwood Ave
Decatur, IL 62526-4371
Mailing address
250 W Kenwood Ave
Decatur, IL 62526-4371
Phone (217) 872-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125-066296 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1245614338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 W KENWOOD AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264371",
"telephone_number": "217-872-3800",
"fax_number": "217-872-0849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 W KENWOOD AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264371",
"telephone_number": "217-872-3800",
"fax_number": "217-872-0849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNTHARALINGAM",
"first_name": "SUJITHTHA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-17",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125-066296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.