Individual provider Active NPI

Sireesha Allamneni, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Oak Lawn, IL
National Provider Identifier
1679723548
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036126032 Issued in IL
Practice address
4440 W 95TH Street
Oak Lawn, IL 60453
Phone
(708) 684-5428
NPI assigned
Sep 26, 2008
Last updated
Jun 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 036126032 IL Primary

Addresses

Primary practice location

4440 W 95TH Street
Oak Lawn, IL 60453

Mailing address

4440 W 95TH Street
Oak Lawn, IL 60453

Other identifiers 1

IdentifierTypeStateIssuer
036126032OtherILSTATE OF IL DIVISION OF PROFESSIONAL REGULATION

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110126000572 IL Practitioner - Physical Medicine and Rehabilitation 6800075623 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036126032ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Specialists of Illinois LLC Physical Medicine & Rehabilitation CurrentSince Mar 5, 2019 Accepting new patients

Locations

301 Springfield Ave
Uppr
Joliet, IL 60435
Phone (815) 630-5119

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1679723548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W 95TH STREET",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH STREET",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-684-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLAMNENI",
        "first_name": "SIREESHA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036126032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL DIVISION OF PROFESSIONAL REGULATION",
            "identifier": "036126032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.