M. Balasubramanian, M.D.

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

C139181 Issued in CA

Practice address

506 E State Pkwy
Schaumburg, IL 60173-4538

Phone

(847) 885-5220

Fax

(847) 755-5170

NPI assigned

Mar 9, 2007

Last updated

Sep 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mani Bala Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Quest Diagnostics LLC Il

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1669298055
  NPD (past)
• Quest Diagnostics LLC Il

  • Clinical Medical Laboratory
  • Wood Dale, IL
  • NPI 1881630614
  NPD (past)
• California Skin Institute, a Medical Corporation

  • Dermatology Physician
  • Mountain View, CA
  • NPI 1154527901

  Dermatopathology

  NPD (past)
• Carlsbad and Vista Dermatology, Inc.

  • Dermatology Physician
  • Vista, CA
  • NPI 1124328505
  NPD (past)
• Omnipath Diagnostics of Texas, LLC

  • Clinical Medical Laboratory
  • Frisco, TX
  • NPI 1548434632
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1760514517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 E STATE PKWY",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734538",
            "telephone_number": "847-885-5220",
            "fax_number": "847-755-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E STATE PKWY",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734538",
            "telephone_number": "847-885-5220",
            "fax_number": "847-755-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2420 Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951243907",
            "country_code": "US",
            "telephone_number": "408-369-5600",
            "fax_number": "408-369-5615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALASUBRAMANIAN",
        "first_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "C139181",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "ND",
            "license": "LT17656",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "IL",
            "license": "36046825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANI",
            "last_name": "BALA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amishi Bajaj, MD
• Mark A Bakal, PSY.D.
• Massarat A Bala, M.D.
• Reshma Balan
• Balance & Wellbeing, LLC
• Katleya Reyes Baldazo, M.S., R.D., L.D.N
• Eizabeth Balentine, LSW
• Christina Marie Balestreri, DPT
• Muhammad Adnan Balouch
• Amar Bamra

• Dermatopathology Physician in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Dermatopathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.