Active NPI
Varathaseelan Muthulingam, MD
- Hospitalist Physician
- Herrin, IL
National Provider Identifier
1417190216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 036122038
- Practice address
- 201 S 14TH St
Herrin, IL 62948-3631 - Phone
- (618) 942-2171
- Fax
- (618) 351-4919
- NPI assigned
- Apr 9, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 036122038 | IL | Primary |
Addresses
Primary practice location
201 S 14TH St
Herrin, IL 62948-3631
Mailing address
P O Box 1105
Indianapolis, IN 46206-1105
Phone (618) 549-5361
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00757187 | Other | IL | RAILROAD MEDICARE |
| 976183 | Other | IL | HEALTHLINK |
| 036122038 | Other | IL | ILLINOIS LICENSE |
| 036122038 | Medicaid | IL | |
| 165651 | Other | IL | HEALTH ALLIANCE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036122038 | IL | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259712000000",
"number": "1417190216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 1105",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462061105",
"telephone_number": "618-549-5361",
"fax_number": "618-549-5128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S 14TH ST",
"city": "HERRIN",
"state": "IL",
"postal_code": "629483631",
"telephone_number": "618-942-2171",
"fax_number": "618-351-4919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTHULINGAM",
"first_name": "VARATHASEELAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-09",
"last_updated": "2009-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036122038",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00757187",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "976183",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS LICENSE",
"identifier": "036122038",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036122038",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "165651",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.