Integramed Medical Illinois, LLC

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

Legal business name

INTEGRAMED MEDICAL ILLINOIS, LLC

Practice address

5401 N Knoxville Ave
Suite 102
Peoria, IL 61614-5098

Phone

(309) 689-0411

NPI assigned

Feb 12, 2014

Last updated

Feb 24, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Satish Vayuvegula, M.D.

Title

Presiden and Secretary

Phone

(309) 689-0411

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1396169280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 102",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-689-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 102",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-689-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAMED MEDICAL ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-12",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "VAYUVEGULA",
        "authorized_official_first_name": "SATISH",
        "authorized_official_title_or_position": "PRESIDEN AND SECRETARY",
        "authorized_official_telephone_number": "309-689-0411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Reproductive Endocrinology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Reproductive Endocrinology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.