Provider Demographics
NPI:1629001805
Name:PERUMAL, KALYANI (MD)
Entity Type:Individual
Prefix:DR
First Name:KALYANI
Middle Name:
Last Name:PERUMAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ADAMS ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-3242
Mailing Address - Country:US
Mailing Address - Phone:312-704-2885
Mailing Address - Fax:312-704-2737
Practice Address - Street 1:1740 W TAYLOR ST
Practice Address - Street 2:DEPT 3462
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7232
Practice Address - Country:US
Practice Address - Phone:312-704-2885
Practice Address - Fax:312-704-2737
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103084207RN0300X
IL036-103084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine