Suresh Duvvada, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036168734 Issued in IL

Practice address

350 N Wall St Ste B302
Kankakee, IL 60901-2901

Phone

(815) 329-6500

Fax

(815) 348-6213

NPI assigned

May 21, 2021

Sex

Male

Sole proprietor

No

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

Internal Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates of Integrated Medicine LTDGroup PAC ID 3779876636, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uplifted Care Hospice, Bourbonnais, IL, CCN 141556
• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Miller Health Care Center Nursing home, Kankakee, IL, CCN 145843

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sduvvada139824@direct.luhs.org

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.

• Associates of Integrated Medicine LTD.

  • Internal Medicine Physician
  • Kankakee, IL
  • NPI 1427407345
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospice of Kankakee Valley, Inc.

  • Community Based Hospice Care Agency
  • Bourbonnais, IL
  • NPI 1811935240
  Care Compare affiliation
• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• Riverside Senior Living Center

  • Skilled Nursing Facility
  • Kankakee, IL
  • NPI 1174603377

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1427623503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N WALL ST STE B302",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012940",
            "telephone_number": "815-329-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WALL ST STE B302",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901",
            "telephone_number": "815-329-6500",
            "fax_number": "815-348-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVVADA",
        "first_name": "SURESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036168734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew J Donofrio, PA-C
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• Duane Dean Behavioral Health Center
• Duane Dean Behavioral Health Center
• Dominik B Dubravec, DDS, MMSC
• Sunny Eartly, OTR/L
• Adnan Ebrahim, PHARM. D
• Daniela Echeverri Idrobo
• Felix El-Daief, M.D.
• Fouzia El-Daief, M.D.

• Internal Medicine Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.