Individual
DR. PALANIKUMAR BALASUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114-2300
(815) 971-7000
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 904-4105
(718) 904-2659
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036163854
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
036.163854
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2018
Last updated
04/13/2026
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