Individual ProviderKalpana MutyalaNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1355 Remington Rd, Suite H, Schaumburg, IL 60173-4832(630) 701-9009PECOS EnrollmentBased on the most recent information from CMS, provider Kalpana Mutyala 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 yesterday at 10:50 AM.Profile DetailsProvider ID1548705056Provider TypeIndividualFull NameMutyala, KalpanaCredentialAPNGenderFemaleSole ProprietorYesEnumeration Date12/20/2016Last Updated12/20/2016Contact InformationPractice LocationPractice Address1355 Remington Rd, Suite H, Schaumburg, IL 60173-4832Phone(630) 701-9009FaxUnlisted FaxMailing LocationMailing Address1355 Remington Rd, Suite H, Schaumburg, IL 60173-4832Phone(630) 701-9009FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209015323Illinois