Healthcare Provider Details

I. General information

NPI: 1376559161
Provider Name (Legal Business Name): PREETHI DONAKONDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. PREETHISAGER PYDA

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 MCHENRY ST
BURLINGTON WI
53105-1828
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 262-767-8000
  • Fax:
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-116480
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number53
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036116480
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: