Sugandhi Mahajan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.070106 Issued in IL

Practice address

611 West Park Street
Imrp College of Medicine Carle Forum LL, MC- 474
Urbana, IL 61801-7109

Phone

(217) 383-3110

NPI assigned

Jul 7, 2017

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720500101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "IMRP COLLEGE OF MEDICINE CARLE FORUM LL, MC- 474",
            "address_2": "611 WEST PARK STREET",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618017109",
            "telephone_number": "217-383-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 WEST PARK STREET",
            "address_2": "IMRP COLLEGE OF MEDICINE CARLE FORUM LL, MC- 474",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618017109",
            "telephone_number": "217-383-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "SUGANDHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.070106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Mackichan, MSW LCSW CADC
• Amanda Madden
• Katherine E Maggio, NP
• Walter Maguire, M.D.
• Corbin Reid Mah, MD
• David M Main, MD
• Meredith Ann Main, M.D.
• Teresa Majers, NP
• Neeka Majzoubi
• Thomas P Malee, OD

• Internal Medicine Physician in Urbana, IL
• Providers in Urbana, 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 21, 2022; 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.