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Physician Compare National (NPI:1629126222)

HEALTHCARE PROVIDER: SUDHA CHERUKURI MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1629126222
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 8527126051
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20130621000453
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name CHERUKURI
Individual professional last name
Provider First Name SUDHA
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1991
Individual professional's medical school graduation year
Primary Specialty NEPHROLOGY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 INTERNAL MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties INTERNAL MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name RENALCARE ASSOCIATES, S.C.
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 7012818347
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 29
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 719 ELLIOTT ST
Group Practice or individual's line 1 address
Line 2 Street Address KEWANEE HOSPITAL
Group Practice or individual's line 2 address
City KEWANEE
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 614432779
Group Practice or individual's zip code (9 digits when available)
Phone Number 3098533361
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 140067
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 OSF SAINT FRANCIS MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 141325
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 OSF SAINT LUKES MEDICAL CENTER
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 141337
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 PERRY MEMORIAL HOSPITAL
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 140209
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 METHODIST MEDICAL CENTER OF ILLINOIS
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 140013
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 PROCTOR HOSPITAL
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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