Provider Demographics
NPI:1326035510
Name:HARSOOR, SUNEELA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNEELA
Middle Name:
Last Name:HARSOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNEELA
Other - Middle Name:
Other - Last Name:GONCHIGAR HANUMANTHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3307
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-3307
Mailing Address - Country:US
Mailing Address - Phone:630-887-9233
Mailing Address - Fax:630-504-6265
Practice Address - Street 1:534 CHESTNUT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3167
Practice Address - Country:US
Practice Address - Phone:630-571-1100
Practice Address - Fax:630-504-6265
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036106992207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK07143Medicare PIN
ILI02694Medicare UPIN