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DEV MITRUKA MD
NPI 1972346724
Student in an Organized Health Care Education/Training Program in La Grange, IL

Active since June 18, 2024PECOS Enrolled
1325 COMMUNITY MEMORIAL DR, LA GRANGE, IL 60525(708) 245-8900 Get Directions Write a Review

NPPES record last updated: June 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dev Mitruka Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEV MITRUKA MD (NPI 1972346724) is an individual student in an organized health care education/training program in La Grange, Illinois and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972346724
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDEV MITRUKACredential: MD
Location Address1325 COMMUNITY MEMORIAL DRLa Grange, IL 60525-2659
Mailing Address1325 Community Memorial DrLa Grange, IL 60525-2659 · (708) 245-8900
Phone(708) 245-8900
Sole ProprietorNo
Enumeration DateJune 18, 2024
NPPES CertifiedJune 18, 2024
✔ NPI 1972346724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1325 COMMUNITY MEMORIAL DR, La Grange, IL 60525
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dev Mitruka Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LEO KOENIG MD
Family Medicine
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8900
GUIA STEPHANIE ALCALA PASCUAL DO
Student in an Organized Health Care Education/Training Program
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8900
AISHAT CAROLYN OIYZA AUDU MD
Student in an Organized Health Care Education/Training Program
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8900
SARAH KAY WELCH DO
Family Medicine
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8900
DANIELLE MARIE GODUTO DO
Student in an Organized Health Care Education/Training Program
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8948
ANERI NITISH SHAH DO
Student in an Organized Health Care Education/Training Program
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8900
DR. DAPHNE TESSALEE MD
Family Medicine
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8900
KATARZYNA HELENA ROGALA MD
Family Medicine
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525
Cook County (708) 245-8900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dev Mitruka's NPI number?

The NPI number for Dev Mitruka is 1972346724. It was assigned to this individual provider in the NPPES registry on June 18, 2024.

Where is Dev Mitruka located?

Dev Mitruka practices at 1325 Community Memorial Dr, La Grange, IL 60525. The listed phone number is (708) 245-8900.

What is Dev Mitruka's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Dev Mitruka enrolled in Medicare?

Yes. Dev Mitruka is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dev Mitruka was last updated on June 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.