Srisudha Reddy Gundala, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036099196 Issued in IL

Practice address

2800 Keslinger Rd Ste 160
Geneva, IL 60134-3753

Phone

(630) 232-7200

Fax

(630) 232-2288

NPI assigned

Jul 8, 2005

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 1

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

Locations

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.

• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844

  Pediatrics

  Medicare reassignment NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1679571236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 KESLINGER RD STE 160",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343753",
            "telephone_number": "630-232-7200",
            "fax_number": "630-232-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 KESLINGER RD STE 160",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343753",
            "telephone_number": "630-232-7200",
            "fax_number": "630-232-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDALA",
        "first_name": "SRISUDHA",
        "middle_name": "REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036099196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099196",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Grzetic, DPT
• Peter Guadagno, MD
• Allison Guimaray, LCSW
• Delaney B Guinan
• Lisandra Guiraldelli, QMHP
• Gustavo M. Banti, M.D., LTD
• April Gutierrez, PT
• Esmeralda Gutierrez, MA ABA
• Magdaleno Aaron Gutierrez, MD, JD
• Vanessa Vazquez Guzman, DO

• Pediatrics Physician in Geneva, IL
• Providers in Geneva, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.