Premsai Chilakuluri

Individual provider Active NPI Internal Medicine Physician · Riverside, IL

NPI 1255252011 · NPPES record last updated Jul 24, 2026

Key facts

NPI
1255252011
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
125.088495 (IL)
Practice address
3722 Harlem Ave
Riverside, IL 60546-2312
Phone
(708) 783-6566
Fax
(708) 783-6566
NPI assigned
Jul 24, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.088495 IL Yes

Addresses

Primary practice location

3722 Harlem Ave
Riverside, IL 60546-2312

Mailing address

3722 Harlem Ave
Riverside, IL 60546-2312
Phone (708) 783-6566

Other providers in Riverside, IL

All providers in Riverside, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.