Jolly Susan Varghese, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Practice address

7600 W. 183Rd St
Tinley Park, IL 60477-3690

Phone

(708) 614-4000

NPI assigned

Feb 9, 2007

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

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

State licenses

Practice roles

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 Department of Human

  • Long Term Care Pharmacy
  • Kankakee, IL
  • NPI 1528111424
  NPD (past)
• Illinois Department of Human Services

  • Psychiatric Hospital
  • Hines, IL
  • NPI 1902903487
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669513735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14151 S 87TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624286",
            "telephone_number": "708-226-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 W. 183RD ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773690",
            "telephone_number": "708-614-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "JOLLY",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly D Van Wyngarden, APRN-BC
• Khai Van, OD
• Vandenberg Med-Tech Equipment, Inc.
• Dawn Marie Vandermeer, FNP
• Monica Vandervoort, PT
• Sara Vari
• Vasantha Kumaraiah,MD,SC
• Vascular Specialists LLC
• Roxanne Faurot Vasilenko, LCSW
• Yolanda Vera Martinez

• Internal Medicine Physician in Tinley Park, IL
• Providers in Tinley Park, 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 Jul 8, 2007; 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.