Active NPI
Soujanya Pulluru, MD
- Family Medicine Physician
- Naperville, IL
National Provider Identifier
1912974940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036110257
- Practice address
- 2940 Rollingridge Rd
Ste 300
Naperville, IL 60564-4216 - Phone
- (630) 646-5800
- NPI assigned
- Mar 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036110257 | IL | Primary |
Addresses
Primary practice location
2940 Rollingridge Rd
Ste 300
Naperville, IL 60564-4216
Mailing address
1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036110257 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WH NJ Medical LLC | Family Medicine | Current | Accepting new patients |
| Walmart Health | Family Medicine | Current | Accepting new patients |
| MC Medical LLC | Family Medicine | Past | Accepting new patients |
| WH Il Medical PLLC | Family Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1912974940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 PAYSPHERE CIR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606740018",
"telephone_number": "630-469-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 ROLLINGRIDGE RD",
"address_2": "STE 300",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605644216",
"telephone_number": "630-646-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULLURU",
"first_name": "SOUJANYA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-08",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036110257",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036110257",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.