NPIMap

Individual provider Active NPI

Sunitha R Avula, MD

  • Internal Medicine Physician
  • Homer Glen, IL
National Provider Identifier
1801895867
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-091789 Issued in IL
Practice address
12701 W 143Rd St
Ste 230
Homer Glen, IL 60491
Phone
(708) 300-6702
NPI assigned
Jul 20, 2005
Last updated
Nov 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-091789 IL Primary

Addresses

Primary practice location

12701 W 143Rd St
Ste 230
Homer Glen, IL 60491

Mailing address

12701 W 143Rd St
Suite 230
Homer Glen, IL 60491
Phone (708) 300-6702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051206000913 IL Practitioner - Internal Medicine 8325068257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292

1900 Silver Cross Blvd
New Lenox, IL 60451-9509

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-091789ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, Inc CurrentSince Mar 1, 2016 Accepting new patients
Health Service Systems, Inc Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients
Primary Health Associates PC Past Accepting new patients

Locations

12701 W 143rd St
Ste 230
Homer Glen, IL 60491
Phone (708) 226-1206

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGEBDA

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1801895867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 W 143RD ST",
            "address_2": "SUITE 230",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "60491",
            "telephone_number": "708-300-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 W 143RD ST",
            "address_2": "STE 230",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "60491",
            "telephone_number": "708-300-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVULA",
        "first_name": "SUNITHA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-091789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

Verify at the official NPI Registry.