DR. SURESH KRISHNAMOORTHY


Address: 1054 M L King Dr, Suite 126, Centralia, IL 62801-3000
Phone: 6185335500

DR. SURESH KRISHNAMOORTHY (NPI# 1760440580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760440580
Entity Type Individual
Full Name DR. SURESH KRISHNAMOORTHY
Credential M.D.
Practice Address 1054 M L King Dr
Suite 126
Centralia
IL 62801-3000
Practice Telephone 6185335500
Practice Fax Number 6185335501
Mailing Telephone 6185335500
Mailing Fax Number 6185335501
Enumeration Date 2006-05-02
Last Update Date 2016-06-30
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0300X Internal Medicine
Specialization: Geriatric Medicine
036091773 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL 036-091773 05

Office Location

Street Address 1054 M L KING DR
SUITE 126
City CENTRALIA
State IL
Zip Code 62801-3000

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912101163 Suresh Krishnamoorthy Md Sc Internal Medicine 1054 M L King Dr, Suite 126, Centralia, IL 62801-3000 2007-06-12
1346251071 Stephen T Ang Internal Medicine 1054 M L King Dr, Suite 120, Centralia, IL 62801-3000 2006-08-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356996151 Matthew Crawford Counselor 904 E Martin Luther King Dr, Centralia, IL 62801 2019-08-08
1588130314 Kennah White Counselor 904 E. Mlk Drive, Centralia, IL 62801 2018-10-19
1245721588 Lindsey Nicole Fogliasso Counselor 904 East Mlk Dr., Centralia, IL 62801 2018-05-22
1629573365 Prabhat Shrestha Student in an Organized Health Care Education/Training Program 605 Sable Drive, Centralia, IL 62801 2018-03-26
1619496098 Whitney Rathmann Speech-Language Pathologist 224 South Locust, Centralia, IL 62801 2017-09-17
1376082685 Athena A Smith Counselor 904 E. Martin Luther King Dr, Centralia, IL 62801 2017-02-20
1447704069 Meghan Branch Counselor 904 Martin Luther King Dr, Centralia, IL 62801 2016-08-11
1568820637 Midland Area Agency On Aging Case Management 434 S Poplar Street, Centralia, IL 62801 2016-02-04
1104201714 Keri Douglas Nurse Practitioner 1054 M. L. King Drive #125, Centrailia, IL 62801 2015-07-24
1215331509 Melissa Dane Counselor 904 E Martin Luther King Dr., Centralia, IL 62801 2014-10-15
Find all providers in zip 62801

Taxonomy Information

Taxonomy Code 207RG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Geriatric Medicine

Taxonomy Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912101163 Suresh Krishnamoorthy Md Sc Internal Medicine 1054 M L King Dr, Suite 126, Centralia, IL 62801-3000 2007-06-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1477058378 Ranim Mira Internal Medicine 4021 W Belle Plaine Ave # Ge, Chicago, IL 60641-2412 2018-03-24
1518351758 Vania Leung Internal Medicine 2600 S Michigan Ave Ste 205, Chicago, IL 60616-2857 2015-03-25
1699174540 Hatem Hassaballa Internal Medicine 840 S Wood St Fl 4, Suite 409 (m/c 717), Chicago, IL 60612-4325 2014-08-16
1528495470 Home Care Doctors of Illinois Inc Internal Medicine 121 Fairfield Way Ste 312, Bloomingdale, IL 60108-1585 2013-10-08
1699059857 We Care for Seniors Ltd Internal Medicine 501 Ashbury Ct, Lemont, IL 60439-8422 2011-10-06
1508181108 Francina Miguelina Peralta Machado Internal Medicine 3046 127th St, Blue Island, IL 60406-1827 2010-04-07
1295976892 Woodridgeclinic-lemont Internal Medicine 15884 W 127th St, Suite H, Lemont, IL 60439-7422 2009-03-12
1609037498 Katya Yanira Cruz Madrid Internal Medicine 840 S. Wood St, Mic 717 Suite 409, Chicago, IL 60612 2008-06-24
1326209446 Downers Grove Geriatrics, LLC Internal Medicine 3800 Highland Ave Ste 111, Downers Grove, IL 60515-1558 2008-06-20
1801060538 Ronald James Grason Internal Medicine 357 W Decatur St, Decatur, IL 62522 2008-04-14
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Competitor

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City CENTRALIA
Zip Code 62801

Improve Information

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Dataset Information

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.

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