Kamala S Chittivelu, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036108302 Issued in IL

Practice address

2501 Allentown Rd
Pekin, IL 61554-9401

Phone

(309) 347-3121

NPI assigned

Jul 5, 2006

Last updated

Nov 27, 2018By the provider in NPPES

Sex

Female

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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1649200346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21333 HAGGERTY RD",
            "address_2": "SUITE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755510",
            "telephone_number": "248-662-0250",
            "fax_number": "248-662-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 ALLENTOWN RD",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615549401",
            "telephone_number": "309-347-3121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 W Court St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609013695",
            "country_code": "US",
            "telephone_number": "815-937-8744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHITTIVELU",
        "first_name": "KAMALA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036108302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108302",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRAHEALTH RR - N. IL",
            "identifier": "P00325405",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Il Chiropractic, LTD
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• Champion Fitness, Inc (CF Physical Therapy)
• Jayne Ann Cheffer
• Saritha Chodavarapu, PHARMD
• Christina Lea Christenberry
• Clanahan Wellness Center Inc
• Todd H Clanahan, DC
• Steven G Clark, MD

• Internal Medicine Physician in Pekin, IL
• Providers in Pekin, 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 Nov 27, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.