Mohanlal Wickramasinghe, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-047140 Issued in IL

Practice address

3450 S Archer Ave
Chicago, IL 60608-6837

Phone

(773) 523-1000

Fax

(773) 843-1553

NPI assigned

Jun 7, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1699715979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606086837",
            "telephone_number": "773-523-1000",
            "fax_number": "773-843-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606086837",
            "telephone_number": "773-523-1000",
            "fax_number": "773-843-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKRAMASINGHE",
        "first_name": "MOHANLAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-047140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047140",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Wickliffe
• Catherine Ann Wicklund, MS, CGC
• Sarah Elizabeth Wicklund, CCC-SLP
• Ian Edward Wickramasekera II, PSY.D.
• Manthushi Eshanya Wickramasinghe
• Carly Wicks, LCSW
• Jennifer Susan Wicks, M.D.
• Nicole Wicks, MA, LPC
• Sheila Michelle Wicks, BSC MS MB,MBA,LAC
• Jancey Lee Wickstrom, MA, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.