Basic Information
Provider Information
NPI: 1548339559
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SUNDARALINGAM
FirstName: ROHAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2650 RIDGE AVE.
Address2: DEPT. OF ANESTHESIA
City: EVANSTON
State: IL
PostalCode: 60201
CountryCode: US
TelephoneNumber: 8475702760
FaxNumber:  
Practice Location
Address1: 2650 RIDGE AVE.
Address2: DEPT. OF ANESTHESIA
City: EVANSTON
State: IL
PostalCode: 60201
CountryCode: US
TelephoneNumber: 8475702760
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/06/2006
LastUpdateDate: 11/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X036098666ILY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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