Vinaya Ramesh Soundararajan, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036172297 Issued in IL

Practice address

1415 W 47TH St
La Grange, IL 60525-6136

Phone

(219) 878-5020

Fax

(219) 861-8146

NPI assigned

Apr 15, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Dermatology Institute, LLCGroup PAC ID 7911043054, 51 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vsoundararajan@illinois.emadirect.md

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.

• Illinois Dermatology Institute, LLC

  • Dermatology Physician
  • Skokie, IL
  • NPI 1891920898
  Medicare reassignment Care Compare group NPD
• Physicians Dermpath Laboratory

  • Dermatopathology Physician
  • Park Ridge, IL
  • NPI 1376866897
  NPD (past)

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1427611565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 S RIDGE RD",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605271921",
            "telephone_number": "630-362-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 W 47TH ST",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605256136",
            "telephone_number": "219-878-5020",
            "fax_number": "219-861-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUNDARARAJAN",
        "first_name": "VINAYA",
        "middle_name": "RAMESH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036172297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Smith, M.ED.
• Brianna Sneed
• Yolanda M Solecki, MA, LCPC, CADC
• Alexander Peter Soneru, MD
• Catherine Bassen Soofi, M.S.CCC-SLP
• Specialty Partners in Anesthesia LLC
• Ashley Speller, DC
• Cristina Nicole Spencer, MA CCC SLPL
• Jenna R. Squillo, BCBA
• Nanci H Stark, APRN

• Dermatology Physician in La Grange, IL
• Providers in La Grange, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.