DR. KALYANA PORURI (NPI# 1548365026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548365026 |
| Entity Type | Individual |
| Full Name | DR. KALYANA PORURI |
| Credential | M.D. |
| Practice Address |
300 Randall Rd Geneva IL 60134-4200 |
| Mailing Address |
825 W State St Suite 103e Geneva IL 60134-2080 |
| Practice Telephone | 6302083000 |
| Mailing Telephone | 6302084412 |
| Mailing Fax Number | 6302080201 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2012-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
036104591 | IL | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
036104591 | IL | Allopathic & Osteopathic Physicians |
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
036104591 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
036104591 | IL | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036104591 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
036104591 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
036104591 | IL | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
036104591 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS PROVIDER ID | 04515240 | 01 |
| Street Address |
300 RANDALL RD |
| City | GENEVA |
| State | IL |
| Zip Code | 60134-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407859655 | Delnor-community Hospital | General Acute Care Hospital | 300 Randall Rd, Geneva, IL 60134-4200 | 2005-05-23 |
| 1811524994 | Daniel Reine | Student in an Organized Health Care Education/Training Program | 300 Randall Rd, Geneva, IL 60134-4200 | 2020-03-26 |
| 1336776400 | Hope Christiansen | Family Medicine | 300 Randall Rd, Geneva, IL 60134-4200 | 2020-03-26 |
| 1962039677 | Ellean Zhang | Family Medicine | 300 Randall Rd, Geneva, IL 60134-4200 | 2020-03-24 |
| 1730716598 | Han Myoung Park | Family Medicine | 300 Randall Rd, Geneva, IL 60134-4200 | 2020-03-23 |
| 1225664220 | Autumn E Bernicky | Student in an Organized Health Care Education/Training Program | 300 Randall Rd, Geneva, IL 60134-4200 | 2020-03-21 |
| 1457985350 | Kinga Radowska | Student in an Organized Health Care Education/Training Program | 300 Randall Rd, Geneva, IL 60134-4200 | 2020-02-28 |
| 1104387885 | Rachel Elizabeth Dewey | Family Medicine | 300 Randall Rd, Geneva, IL 60134-4200 | 2019-03-26 |
| 1649739913 | Evan Justin Hale | Family Medicine | 300 Randall Rd, Geneva, IL 60134-4200 | 2019-03-17 |
| 1124557152 | Josephine Soyoung Lee-kim | Hospitalist | 300 Randall Rd, Geneva, IL 60134-4200 | 2017-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403918 | Glenda Creighton | Physical Therapist | 0n 801 Friendship Way, Geneva, IL 60134 | 2020-10-02 |
| 1467912212 | Cierra Monae French | Family Medicine | Northwestern Medicine Delnor Hospital, 300 Randall Road, Geneva, IL 60134 | 2019-03-20 |
| 1497246227 | Linda Huber | Psychologist | 1541 E Fabyan Pkwy Ste 101, Geneva, IL 60134 | 2018-05-29 |
| 1003305459 | Nicole Collins | Specialist/Technologist | 1125 Lewis Road, Geneva, IL 60134 | 2018-05-01 |
| 1013438704 | Emily Byars | Clinic/Center | 1111 Greenfield Circle, Geneva, IL 60134 | 2017-07-03 |
| 1982142980 | Samantha Courtney | Counselor | 1120 Randall Ct., Geneva, IL 60134 | 2017-02-09 |
| 1073055026 | Physical Rehabilitation Clinics | Physical Therapist | 507 S. 3rd St. Unit I, Geneva, IL 60134 | 2016-11-08 |
| 1265868707 | Gina Marie Gilchrist | Dietitian, Registered | 39w479 W Haladay Ln, Geneva, IL 60134 | 2013-09-16 |
| 1770823585 | William A. Goodfellow | General Practice | 1010 S. Batavia Ave., Geneva, IL 60134 | 2013-02-15 |
| 1467705392 | Kylie L Mack | Physician Assistant | 351 Delnor Dr #100, Geneva, IL 60134 | 2012-10-16 |
| Find all providers in zip 60134 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245490903 | Cdi Geneva LLC | Radiology | 1416 S Randall Rd, Suite C1, Geneva, IL 60134-4682 | 2008-06-16 |
| 1336320001 | Valley Imaging Vt, LLC | Radiology | 407 S 3rd St, Ste 240, Geneva, IL 60134-2741 | 2007-11-21 |
| 1851346159 | Finger Lakes Bone and Joint LLP | Radiology | 875 Pre Emption Rd, Geneva, NY 14456-2042 | 2006-05-24 |
| 1114979036 | Patrick Francis Para | Radiology | 1416c S Randall Rd, Randall Square Shopping Center, Geneva, IL 60134-4682 | 2006-05-17 |
| 1902857881 | Randallwood Radiology Associates, S. C. | Radiology | 1416c South Randall Road, Randall Square Shopping Center, Geneva, IL 60134 | 2006-05-15 |
| 1013968163 | Mohsin A Sheikh | Radiology | 1792 S Randall Rd, Geneva, IL 60134-4602 | 2006-05-13 |
| 1942261722 | James Lincoln | Radiology | 35 Mason St, Geneva, NY 14456-1133 | 2006-03-31 |
| 1326018375 | Rodolfo Queiroz | Radiology | 196 North St, Geneva, NY 14456-1651 | 2006-01-24 |
| 1285990564 | Fatma Youssef Ahmed | Radiology | 300 Randall Rd, Geneva, IL 60134-4200 | 2012-04-11 |
| 1902193873 | Amar Pradip Patel | Radiology | 825 W State St Ste 103e, Geneva, IL 60134-2078 | 2011-06-29 |
| Find all providers in GENEVA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.