Omprakash N. Sureka, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036-058320 Issued in IL

Practice address

5431 W. Stonebridge CT.
Peoria, IL 61615-2932

Phone

(309) 691-8149

NPI assigned

Jun 17, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1518902469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5431 W STONEBRIDGE CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152268",
            "telephone_number": "309-691-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5431 W. STONEBRIDGE CT.",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152932",
            "telephone_number": "309-691-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUREKA",
        "first_name": "OMPRAKASH",
        "middle_name": "N.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-058320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058320",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "07223459",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE PROVIDER NUMBE",
            "identifier": "370681567-01",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE NUMBER",
            "identifier": "009035",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "250004537",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ishwarya Sundararajan
• Sithara Sunny
• Kathrine Sunstedt, CPNP-AC
• Support a Friend Transportation LLC
• Supportive Steps Home Healthcare
• Rachana Sureka, MD
• Erin Surratt, LCSW
• Susan J Cole, MD & Associates
• Sally Sutkowski, R, P.T.
• Jonathan R Sutter, PT, DPT

• Physical Medicine & Rehabilitation Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.