Provider Demographics
NPI:1962800581
Name:MEDGENIUS INC.
Entity type:Organization
Organization Name:MEDGENIUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUJITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDARARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-505-3000
Mailing Address - Street 1:107 FOREST EDGE DR
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1949
Mailing Address - Country:US
Mailing Address - Phone:312-505-3000
Mailing Address - Fax:
Practice Address - Street 1:107 FOREST EDGE DR
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1949
Practice Address - Country:US
Practice Address - Phone:312-505-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty