Provider Demographics
NPI:1366448128
Name:KALIMUTHU, RAMASAMY (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMASAMY
Middle Name:
Last Name:KALIMUTHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5346 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2452
Mailing Address - Country:US
Mailing Address - Phone:708-636-8222
Mailing Address - Fax:708-636-9798
Practice Address - Street 1:5346 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2452
Practice Address - Country:US
Practice Address - Phone:708-636-8222
Practice Address - Fax:708-636-9798
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360560732082S0105X, 2086S0122X, 2086S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036056073Medicaid
ILC45799Medicare UPIN
IL036056073Medicaid