SUJITHRA REPRAKASH (NPI# 1699330811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699330811 |
| Entity Type | Individual |
| Full Name | SUJITHRA REPRAKASH |
| Credential | PA-C |
| Practice Address |
364 Torrence Ave Calumet City IL 60409-1902 |
| Mailing Address |
378 Deering Ln Bolingbrook IL 60440-6165 |
| Practice Telephone | 7732334100 |
| Practice Fax Number | 7088686910 |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085006949 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
364 TORRENCE AVE |
| City | CALUMET CITY |
| State | IL |
| Zip Code | 60409-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356459549 | Theisha Y Perkins | Pediatrics | 364 Torrence Ave, Calumet City, IL 60409 | 2006-08-28 |
| 1457869992 | Rachel O Ilesanmi | Nurse Practitioner | 364 Torrence Ave, Calumet City, IL 60409-1902 | 2018-01-18 |
| 1043570310 | Christian Community Health Center | Internal Medicine | 364 Torrence Ave, Calumet City, IL 60409-1902 | 2012-05-21 |
| 1780857219 | Christian Community Health Center | Clinic/Center | 364 Torrence Ave, Calumet City, IL 60409-1902 | 2008-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689159832 | Victory Pharmacy of Decatur Inc | Pharmacy | 1837 River Oaks Rd, Calumet City, IL 60409 | 2018-10-03 |
| 1801336961 | It's About Change Sober Living, Inc. | Community/Behavioral Health | 1604 Horbor St., Calumet City, IL 60409 | 2017-03-08 |
| 1750832986 | Jeffrey Mcneil | Social Worker | 660 Memorial Dr., Calumet City, IL 60409 | 2016-10-24 |
| 1578855219 | Cherechi V Onyenso | Nurse Practitioner | 1473 Ring Ring Road, Great Heights Family Medicine, Calumet City, IL 60409 | 2011-05-13 |
| 1205097607 | Michael Peter Weisberg | Ophthalmology | 1700 East West Road, Calumet City, IL 60409 | 2008-06-19 |
| 1861694333 | County of Cook | Local Education Agency (LEA) | 1255 Superior Ave, Calumet City, IL 60409 | 2007-06-05 |
| 1689875585 | Calumet City School District #155 | Local Education Agency (LEA) | Memorial Dr and Superior, Calumet City, IL 60409 | 2007-05-29 |
| 1932224185 | Micah K Swansey Sr. | Psychologist | 593 Burnham Avenue, Calumet City, IL 60409 | 2007-03-20 |
| 1184768210 | Beverly Williamson | Optometrist | 200 River Oaks Drive, Calumet City, IL 60409 | 2007-02-20 |
| 1205978863 | Dillons Dental Services LLC | Dentist | 2000 E 159th St, Calumet City, IL 60409 | 2007-02-12 |
| Find all providers in zip 60409 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063796563 | Kristin Victoria Hofer | Physician Assistant | 1600 Torrence Ave, Calumet City, IL 60409-5430 | 2011-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
| City | CALUMET CITY |
| Zip Code | 60409 |
Please comment or provide details below to improve the information on SUJITHRA REPRAKASH.
| 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.