Surendra P Paruchuri, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036061132 Issued in IL

Practice address

707 N Logan Ave
Danville Polyclinic, LTD.
Danville, IL 61832-4360

Phone

(217) 477-4730

Fax

(217) 477-4749

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1902847437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N LOGAN AVE",
            "address_2": "DANVILLE POLYCLINIC, LTD.",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324360",
            "telephone_number": "217-477-4730",
            "fax_number": "217-477-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N LOGAN AVE",
            "address_2": "DANVILLE POLYCLINIC, LTD.",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324360",
            "telephone_number": "217-477-4730",
            "fax_number": "217-477-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARUCHURI",
        "first_name": "SURENDRA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036061132",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036061132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100014800A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061132",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "22387",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE/COVENTRY",
            "identifier": "170580",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven H. Packard, M.D.
• Justin Padaoan, LCSW
• Page Family Chiropractic Clinic Inc
• Gary Dean Page Jr., CHIROPRACTOR
• Andy Sungsoon Park, D.C.
• Usha R. Paruchuri, M.D.
• Paul Michael Pasquale, RPH
• Brandon Lloyd Pastorel, NP-C
• Bhaskar N Patel, M.D.
• Harikrishna P Patel, MD

• Internal Medicine Physician in Danville, IL
• Providers in Danville, 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 12, 2015; 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.