Prana Center for Asthma and Allergy LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

036078244 Issued in IL

Legal business name

PRANA CENTER FOR ASTHMA AND ALLERGY LLC

Practice address

6857 Kingery Highway
Willowbrook, IL 60527

Phone

(630) 323-8800

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Samyukta Koppula, MDNPI 1770641763

Title

Owner

Phone

(630) 323-8800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samyukta Koppula, M.D.

  • Allergy & Immunology Physician
  • Willowbrook, IL
  • NPI 1770641763
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1821211491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6714 FIELDSTONE DR",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "60527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6857 KINGERY HIGHWAY",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-323-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRANA CENTER FOR ASTHMA AND ALLERGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "KOPPULA",
        "authorized_official_first_name": "SAMYUKTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-323-8800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036078244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisol Pineda
• Pamela D Piszczek, APRN, FNP-C
• Madison Podjasek, DPT
• Amanda Jo Pohrebny, RBT
• Charlotte A Porcaro, PHARMACIST
• Lingasetty Prasannakumar, M.D.
• Precise Bioscience, LLC
• Primary Health Care LLC
• Pure Wellness Clinic, PLLC
• Christy M Pyzik, APN, FNP-BC

• Allergy & Immunology Physician in Willowbrook, IL
• Providers in Willowbrook, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.