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

Kunjumol Pullathra Velayudhan, ANP

Individual provider Adult Health Nurse Practitioner · NPI 1124215264

Kunjumol Pullathra Velayudhan, ANP is a Nurse Practitioner in Evergreen Park, Illinois. Qualified in 2005, 21 years ago. Practices with Skyline Physicians LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
21
Licensed in
IL
In the registry since
2007

Practice location Address checks out

3650 W 95th St
Evergreen Park, IL 60805-2108
Phone: (708) 422-7715
Fax: (708) 422-7816
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 209006239 (IL)

Record details

NPI number1124215264
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP
Sole proprietorNo
NPI enumeratedOctober 3, 2007
Last updated in NPPESFebruary 25, 2009

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Skyline Physicians Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Evergreen Park