MEDICARE: SUDHAKARA P. PARUCHURI M.D.

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	207L00000X	Anesthesiology Physician	036078480	IL

General Provider Information

NPI Number	:	1821099854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUDHAKARA P. PARUCHURI M.D.

Provider Business Mailing Address
First Line	:	387 SHUMAN BLVD STE 240W
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-8113
Country	:	US
Telephone Number	:	630-868-2200
Fax Number	:	630-868-2240

Provider Business Practice Location Address
First Line	:	3815 HIGHLAND AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1500
Country	:	US
Telephone Number	:	630-275-6699
Fax Number	:

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

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	12/20/2021

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