MRS. GURRAMKONDA NAIDU M.D. NPI 1528089687

Family Medicine in Peoria, IL

About GURRAMKONDA NAIDU

Gurramkonda Naidu is a provider in Peoria, IL. The NPI number assigned to this provider is 1528089687. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an individual and their NPI record was last updated 10 years ago. Gurramkonda Naidu is registered with Medicare.

NPI1528089687 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameMRS. GURRAMKONDA NAIDU M.D.
Provider Location Address120 NE GLEN OAK AVE SUITE 306 PEORIA, IL 61603 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address5000 RELIABLE PKWY CHICAGO, IL 60682 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date07-22-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-08-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

MRS. GURRAMKONDA NAIDU M.D.
120 NE GLEN OAK AVE
SUITE 306
PEORIA, IL
ZIP 61603
Phone: (309) 672-4582
Fax: (309) 672-4552
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Mailing Address

MRS. GURRAMKONDA NAIDU M.D.
5000 RELIABLE PKWY
CHICAGO, IL
ZIP 60682
Phone: (309) 672-4582
Fax: (309) 672-4552

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.036058664
License StateIL
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0116OTHER (01)IL
140209MEDICARE ID-TYPE UNSPECIFIED (04)IL
001011OTHER (01)IL
115958OTHER (01)IL
A61636OTHER (01)IL
G16092MEDICARE UPIN (02)IL
370661223001MEDICAID (05)IL
370661223401MEDICAID (05)IL

Map Location


MRS. GURRAMKONDA NAIDU M.D. address is 120 NE GLEN OAK AVE SUITE 306 PEORIA, IL 61603

Other Providers at the same location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063538940 JOAN K SELBURG CST
Individual
120 NE GLEN OAK AVE SUITE 407
PEORIA, IL 61603
(309) 672-5975
1104986330MRS. DIANE LYNN DUNNIWAY NPP
Individual
Nurse Practitioner (Obstetrics & Gynecology)120 NE GLEN OAK AVE SUITE 200
PEORIA, IL 61603
(309) 673-0000
1184670663METHODIST MEDICAL CENTER OF ILLINOIS
Organization
Family Medicine120 NE GLEN OAK AVE SUITE 101
PEORIA, IL 61603
(309) 671-8230
1225145196DR. DANIEL W PALMER JR. MD
Individual
Specialist120 NE GLEN OAK AVE SUITE 408
PEORIA, IL 61603
(309) 672-3158
1225234206ALLERGY AND ASTHMA CARECENTER SC
Organization
Clinic/Center120 NE GLEN OAK AVE SUITE 408
PEORIA, IL 61603
(309) 672-3158
1609936707KINDRED LLC
Organization
Obstetrics & Gynecology (Obstetrics)120 NE GLEN OAK AVE SUITE 200
PEORIA, IL 61603
(309) 673-0000
1811901929 JOSEPH COURI MD
Individual
Internal Medicine (Rheumatology)120 NE GLEN OAK AVE SUITE 100
PEORIA, IL 61603
(309) 671-8270
1871047977 MAREN THOMPSON PHARM D
Individual
Pharmacist (Ambulatory Care)120 NE GLEN OAK AVE SUITE 301
PEORIA, IL 61603
(309) 648-1359
1912912213 VAUGHN HANNA MD
Individual
Internal Medicine (Rheumatology)120 NE GLEN OAK AVE SUITE 100
PEORIA, IL 61603
(309) 671-8270