MR. BHADRA DEV KOMARRAJU (NPI# 1831529296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831529296 |
| Entity Type | Individual |
| Full Name | MR. BHADRA DEV KOMARRAJU |
| Credential | APRN AGNP-C |
| Practice Address |
4415 Harrison St Hillside IL 60162-1910 |
| Mailing Address |
Po Box 45 Madison IL 62060-0045 |
| Practice Telephone | 3127383355 |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2018-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209010785 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
209010785 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4415 HARRISON ST |
| City | HILLSIDE |
| State | IL |
| Zip Code | 60162-1910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902845126 | In Home Health LLC | Home Health | 4415 Harrison St, Suite 403, Hillside, IL 60162-1910 | 2006-06-05 |
| 1447632575 | Chrysalis Consulting Group, Inc. | Case Management | 4415 Harrison St, Suite 201, Hillside, IL 60162-1910 | 2015-06-25 |
| 1750792131 | Community Care Systems, Inc. | In Home Supportive Care | 4415 Harrison St, Suite 405, Hillside, IL 60162-1910 | 2014-05-19 |
| 1396025664 | Physician Care Partners, Inc. | Health Maintenance Organization | 4415 Harrison St, Suite 300, Hillside, IL 60162-1910 | 2011-08-18 |
| 1578741526 | Swedish Covenant Managed Care Alliance, Inc. | Health Maintenance Organization | 4415 Harrison St, Suite 300, Hillside, IL 60162-1910 | 2008-02-01 |
| 1619008935 | Holy Cross Health Partners | Health Maintenance Organization | 4415 Harrison St, 300, Hillside, IL 60162-1910 | 2007-03-08 |
| 1124169412 | Namm Partners, Inc. | Health Maintenance Organization | 4415 Harrison St, Suite 300, Hillside, IL 60162-1910 | 2007-02-09 |
| 1194866574 | Affiliated Physicians Group, L.L.C. | Health Maintenance Organization | 4415 Harrison St, Suite 300, Hillside, IL 60162-1910 | 2007-02-09 |
| 1710028972 | Oak West Primary Physician Organization | Health Maintenance Organization | 4415 Harrison St, Suite 300, Hillside, IL 60162-1910 | 2007-02-09 |
| 1154484491 | Ingalls Provider Group | Health Maintenance Organization | 4415 Harrison St, Suite 300, C-o North American Medical Management, Hillside, IL 60162-1910 | 2006-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508345216 | Oakwood Medical Services Inc | Durable Medical Equipment & Medical Supplies | 4747 Charles St, Hillside, IL 60162 | 2018-08-13 |
| 1316187453 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 120 S Mannheim Road, H01, Hillside, IL 60162 | 2009-03-03 |
| 1679729891 | Daniel J. Desalvo | Dentist | 321 N. Hillside Ave, Hillside, IL 60162 | 2008-08-08 |
| 1124163332 | Aspire of Illinois | Occupational Therapist | 1815 S Wolf Rd, Hillside, IL 60162 | 2007-02-21 |
| 1558409243 | Sayeeda Yasmin | Internal Medicine | Renaissance At Hillside, Hillside, IL 60162 | 2007-02-02 |
| 1114088226 | Health Options of Il, Inc | Case Management | 4415 W. Harrison Street, 300, Hillside, IL 60162 | 2006-12-12 |
| 1699860213 | Hinsdale Physicians Healthcare Association, Inc. | Health Maintenance Organization | 4415 West Harrison Street, Suite 300, Hillside, IL 60162 | 2006-10-03 |
| 1467477059 | Magdoleen Nessim | Internal Medicine | 4413 W Roosvelt Rd, 101, Hillside, IL 60162 | 2006-07-13 |
| 1174030381 | Kristian Shumate | Occupational Therapist | 1815 S Wolf Rd, Hillside, IL 60162 | 2018-01-09 |
| 1710374988 | Kimberly Charo | Registered Nurse | 5024 W Hawthorne Ave, Hillside, IL 60162-1010 | 2015-04-24 |
| Find all providers in zip 60162 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588130058 | Edna Kerubo Akombe | Nurse Practitioner | 233 Fitzpatrick St, Hillside, NJ 07205-2125 | 2018-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553472 | Nicholas Johnson | Nurse Practitioner | 8455 S Luella Ave, Chicago, IL 60617-1953 | 2020-09-23 |
| 1710592175 | Mary Maloney | Nurse Practitioner | 348 Westglen Dr, Glen Carbon, IL 62034-1002 | 2020-09-12 |
| 1134738800 | Benjamin Scott Hulfachor | Nurse Practitioner | 4143 N Central Park Ave Apt G, Chicago, IL 60618-2062 | 2020-07-28 |
| 1083222368 | Izolda Rosario | Nurse Practitioner | 501 W Lake St Ste 207, Elmhurst, IL 60126-1419 | 2020-07-22 |
| 1043832785 | Melanie Glander | Nurse Practitioner | 18357 Cowing Ct, Homewood, IL 60430-3332 | 2020-05-16 |
| 1699306902 | Ife Muyiwa-ojo | Nurse Practitioner | 729 E Carpenter St, Springfield, IL 62702-5321 | 2020-01-27 |
| 1962040345 | Doctors Orders Inc. | Nurse Practitioner | 5113 S Harper Ave Ste 2, Chicago, IL 60615-4119 | 2019-12-16 |
| 1801455993 | Parul Arora | Nurse Practitioner | 1717 W Congress Pkwy Ste 1125, Chicago, IL 60612-3809 | 2019-06-11 |
| 1891358222 | Kelly Jo Erke | Nurse Practitioner | 20830 N 1970 East Rd, Danville, IL 61834-6228 | 2019-04-22 |
| 1689136319 | Brittany Sue Borkowski | Nurse Practitioner | 5841 S Maryland Ave # W700, Chicago, IL 60637-1443 | 2019-04-02 |
| Find all providers with the same taxonomy | ||||
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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.