Individual provider Active NPI

Sunitha Rachel Chandy, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1003965930
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008056 Issued in IL
Practice address
77 W Washington St Ste 1500
Chicago, IL 60602-3219
Phone
(773) 980-9679
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 22361 CA
Clinical Psychologist 103TC0700X 071008056 IL Primary

Addresses

Primary practice location

77 W Washington St Ste 1500
Chicago, IL 60602-3219

Mailing address

1402 N Artesian Ave
Chicago, IL 60622-1703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110520000651 IL Practitioner - Clinical Psychologist 9830375104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Artesian Collaborative, LLCGroup PAC ID 2365831609, 5 clinicians

Practice addresses (Care Compare)

77 W Washington St
Suite 1500
Chicago, IL 60602-3219
Phone (773) 980-9679

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22361CAMDClinical Psychologist
071008056ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Artesian Collaborative, LLC Clinical CurrentSince Aug 11, 2017 Accepting new patients

Locations

73 W Monroe St
Ste 206
Chicago, IL 60603
Phone (312) 572-9581

77 W Washington St
Ste 1500
Chicago, IL 60602
Phone (773) 980-7679

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1003965930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 N ARTESIAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W WASHINGTON ST STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023219",
            "telephone_number": "773-980-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDY",
        "first_name": "SUNITHA",
        "middle_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "22361",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.