Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Goutham Kondapi

Individual provider Nephrology Physician · NPI 1245792175

Goutham Kondapi is a Nephrology in Evergreen Park, Illinois. Qualified in 2022, 4 years ago. Practices with Nephrology Associates of Northern Illinois Ltd, a 117-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2019
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Practice location Address checks out

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone: (708) 422-7715
Fax: (708) 422-7816
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 5841 S Maryland Ave # Mc5100, Chicago, IL 60637-1443 — (773) 702-3630
  • 16605 S 107th Court, Orland Park, IL 60467 — (708) 226-9860
  • 22201 Moross Rd Ste 50, Detroit, MI 48236-2166 — (313) 343-7774

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 036160201 (IL)

Record details

NPI number1245792175
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 1, 2019
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024
Mailing address120 W 22nd St, Oak Brook, IL 60523-1557

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Nephrology Associates Of Northern Illinois Ltd — 117 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Evergreen Park