Dekalb Medical Clinic,Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-099204 Issued in IL

Legal business name

DEKALB MEDICAL CLINIC,INC

Doing business as

Dekalb Internal Medicine

Practice address

2128 Midlands CT
Suite 106
Sycamore, IL 60178-3199

Phone

(815) 756-1434

NPI assigned

Apr 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Vasantha L Gona, M.D.,

Title

Staff Physician

Phone

(352) 857-9150

Specialties & licenses 1

Addresses

Other names 1

• Dekalb Internal Medicine Doing business as

Locations

Practitioners 1

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

• Periakaruppan Ramanathan, MD

  • Internal Medicine Physician
  • Sycamore, IL
  • NPI 1235237082
  NPD (past)

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1891969549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 MIDLANDS CT",
            "address_2": "SUITE 106",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783199",
            "telephone_number": "815-756-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 MIDLANDS CT",
            "address_2": "SUITE 106",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783199",
            "telephone_number": "815-756-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB MEDICAL CLINIC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "GONA",
        "authorized_official_first_name": "VASANTHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "STAFF PHYSICIAN",
        "authorized_official_telephone_number": "352-857-9150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-099204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dekalb Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph C Dearie, MD
• Dekalb Clinic Chartered
• Dekalb Clinic Chartered
• Dekalb Eye Consultants, LLC (Arlington Eye Physicians)
• Dekalb Hearing Services, LLC (Hauser-Ross Hearing Services)
• Dekalb Optical Shop LLC (Hauser-Ross Optical)
• Dekalb Surgical Services, LLC
• Geraldine Maniago Delos Santos, D.O.
• Thomas Dennison, M.D.
• Dental Professionals of Illinois, P.C. (Family Dental Care of Sycamore)

• Internal Medicine Physician in Sycamore, IL
• Providers in Sycamore, 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 Jan 25, 2012; 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.