Individual provider Active NPI

Meghana Kunduru, MD

  • Pediatric Adolescent Medicine Physician
  • Arlington Heights, IL
National Provider Identifier
1679937791
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
036150413 Issued in IL
Practice address
3335 N Arlington Heights Rd Ste C
Arlington Heights, IL 60004-1573
Phone
(847) 788-8300
Fax
(847) 788-8306
NPI assigned
Apr 6, 2016
Last updated
May 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 036150413 IL Primary

Addresses

Primary practice location

3335 N Arlington Heights Rd Ste C
Arlington Heights, IL 60004-1573

Mailing address

3335 N Arlington Heights Rd Ste C
Arlington Heights, IL 60004-1573
Phone (847) 788-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181218003794 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8921343062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036150413ILMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Suburban Pediatrics, S.C. Single Specialty Current Accepting new patients

Locations

455 S Roselle Rd
Ste 209
Schaumburg, IL 60193
Phone (847) 352-9910

Interoperability endpoints

  • Direct secure messaging: mkunduru293389@direct.myadvocateaurora.org

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1679937791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 N ARLINGTON HEIGHTS RD STE C",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041573",
            "telephone_number": "847-788-8300",
            "fax_number": "847-788-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 N ARLINGTON HEIGHTS RD STE C",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041573",
            "telephone_number": "847-788-8300",
            "fax_number": "847-788-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNDURU",
        "first_name": "MEGHANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036150413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.