Provider Demographics
NPI:1699861575
Name:PARUCHURI, USHA R (MD)
Entity type:Individual
Prefix:
First Name:USHA
Middle Name:R
Last Name:PARUCHURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:USHA
Other - Middle Name:R
Other - Last Name:KASARENENJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:707 N LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4360
Mailing Address - Country:US
Mailing Address - Phone:217-477-4707
Mailing Address - Fax:217-477-4749
Practice Address - Street 1:707 N LOGAN AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4360
Practice Address - Country:US
Practice Address - Phone:217-477-4707
Practice Address - Fax:217-477-4749
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036067445207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine