Individual ProviderSunil KiniRadiologyAllopathic & Osteopathic PhysiciansPractice Address2160 S 1st Ave, Maywood, IL 60153-3328(708) 216-9000(954) 847-9297PECOS EnrollmentBased on the most recent information from CMS, provider Sunil Kini is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1215996681Provider TypeIndividualFull NameKini, SunilCredentialMDGenderMaleSole ProprietorNoEnumeration Date3/22/2006Last Updated4/26/2023Contact InformationPractice LocationPractice Address2160 S 1st Ave, Maywood, IL 60153-3328Phone(708) 216-9000FaxUnlisted FaxMailing LocationMailing Address727 Potranco Rd., Apt. 2104, San Antonio, TX 78251Phone(954) 847-9297FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseC160552CaliforniaCode2085R0202XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense058050GeorgiaCode2085R0202XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense4301076286MichiganCode2085R0202XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense036130392IllinoisProvider IdentifiersIDDescriptionIssuerID4749634DescriptionMedicaidIssuerUnlistedMichiganID300F362420DescriptionOtherIssuerBCBSMMichigan