Individual provider Active NPI

Preethi Lakshmi Raghupatruni, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1306136528
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036134698 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-4000
Fax
(314) 498-6082
NPI assigned
Apr 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036134698 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

505 N McClurg CT Apt 803
Unit 1601
Chicago, IL 60611-5376
Phone (314) 498-6082

Other practice location 1

3600 W Fullerton Ave
Infant Welfare Society of Chicago
Chicago, IL 60647-2319
Phone (773) 782-2800

Other names 1

  • Dr. Preethi L. Rangachari Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141006000644 IL Practitioner - Pediatric Medicine 7810117314 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036134698ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group Inc Pediatrics CurrentSince Jan 14, 2019 Accepting new patients
Lurie Children'S Medical Group, LLC Pediatrics Past Accepting new patients

Locations

Claims Remittance
Carol Stream, IL 60122

4867 N Broadway St
Chicago, IL 60640
Phone (312) 227-2610

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#118
Chicago, IL 60611

Organizations & group practices 2

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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1306136528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N MCCLURG CT APT 803",
            "address_2": "UNIT 1601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115376",
            "telephone_number": "314-498-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4000",
            "fax_number": "314-498-6082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 W Fullerton Ave",
            "address_2": "Infant Welfare Society of Chicago",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606472319",
            "country_code": "US",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAGHUPATRUNI",
        "first_name": "PREETHI",
        "middle_name": "LAKSHMI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036134698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PREETHI",
            "last_name": "RANGACHARI",
            "middle_name": "L.",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.