Individual
BALARAMA KRISHNA SURAPANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
Mailing address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036174489
IL
207R00000X
Internal Medicine Physician
MD-50099
IA
208M00000X
Hospitalist Physician
MD-50099
IA
Other
Enumeration date
03/27/2018
Last updated
04/08/2026
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