Provider Demographics
NPI:1386605525
Name:KUMAR, SUNITA (MD)
Entity type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:(17W740 22ND STREET, OAKBROOK TERRACE, IL. 60181)
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153
Mailing Address - Country:US
Mailing Address - Phone:630-627-7399
Mailing Address - Fax:630-627-7079
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:(17W740 22ND STREET, OAKBROOK TERRACE, IL. 60181)
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153
Practice Address - Country:US
Practice Address - Phone:630-627-7399
Practice Address - Fax:630-627-7079
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036101201207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036101201Medicaid
IL036101201Medicaid