Bertin Puthankudy

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.490145 Issued in IL

Practice address

4825 W Randolph St
Hillside, IL 60162-1018

Phone

(224) 478-3789

NPI assigned

Sep 29, 2026

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1831003805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 W RANDOLPH ST",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621018",
            "telephone_number": "224-478-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 W RANDOLPH ST",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621018",
            "telephone_number": "224-478-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHANKUDY",
        "first_name": "BERTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.490145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Hillside, IL
• Providers in Hillside, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.