MEDICARE: SUNDER VINODKUMAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036070921	IL
2	207RG0100X	Gastroenterology Physician	036070921	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0031601740	OTHER	IL	BC-BS
3	P00074706	OTHER	IL	RAILROAD

General Provider Information

NPI Number	:	1699777052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNDER VINODKUMAR MD

Provider Business Mailing Address
First Line	:	500 LAVERGNE AVE
Second Line	:
City	:	WILMETTE
State	:	IL
Zip	:	60091-2024
Country	:	US
Telephone Number	:	847-594-1805
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 LAVERGNE AVE
Second Line	:
City	:	WILMETTE
State	:	IL
Zip	:	60091-2024
Country	:	US
Telephone Number	:	847-594-1805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	01/25/2026

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Directions to “ SUNDER VINODKUMAR MD” Practice Location

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