Active NPI
Sushitha Suraparaju, M.P.T
- Physical Therapist
- Chicago, IL
National Provider Identifier
1649583915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.017525
- Practice address
- 1401 North California Ave
Genesis Rehab
Chicago, IL 60622 - Phone
- (773) 276-5767
- NPI assigned
- Jul 15, 2010
- Last updated
- Jul 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.017525 | IL | Primary |
Addresses
Primary practice location
1401 North California Ave
Genesis Rehab
Chicago, IL 60622
Mailing address
110 N Kenilworth Ave
Apt 6D
Oak Park, IL 60301
Phone (909) 499-9515
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.017525 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279152000000",
"number": "1649583915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 N KENILWORTH AVE",
"address_2": "APT 6D",
"city": "OAK PARK",
"state": "IL",
"postal_code": "60301",
"telephone_number": "909-499-9515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 NORTH CALIFORNIA AVE",
"address_2": "GENESIS REHAB",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60622",
"telephone_number": "773-276-5767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURAPARAJU",
"first_name": "SUSHITHA",
"name_prefix": "Mrs.",
"credential": "M.P.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-15",
"last_updated": "2010-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.017525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.