Provider Demographics
NPI:1063517746
Name:KUMAR, ADARSH A (MD)
Entity type:Individual
Prefix:DR
First Name:ADARSH
Middle Name:A
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:2040 TIMBERBROOKE DRIVE
Mailing Address - Street 2:DERMATOLOGY & SKIN SURGERY
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702
Mailing Address - Country:US
Mailing Address - Phone:217-787-2511
Mailing Address - Fax:217-787-2513
Practice Address - Street 1:2040 TIMBERBROOKE DRIVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702
Practice Address - Country:US
Practice Address - Phone:217-787-2511
Practice Address - Fax:217-787-2513
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036044781207ND0900X, 207NI0002X, 207NP0225X
IL3644781207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036044781Medicaid
ILD10994Medicare UPIN
IL036044781Medicaid