NPIMap

Organization Active NPI

Kalyan Sandesara MD SC

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1073757571
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036065899 Issued in IL
Legal business name
KALYAN SANDESARA MD SC
Practice address
1008 N Western Ave
Chicago, IL 60622-3565
Phone
(773) 342-3600
Fax
(773) 342-4503
NPI assigned
Apr 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Authorized official

Name
Kalyan Sandesara, M.D.NPI 1811053978
Title
President of the Corporation
Phone
(773) 342-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 036065899 IL Primary

Addresses

Primary practice location

1008 N Western Ave
Chicago, IL 60622-3565

Mailing address

2410 Halina Dr E
Glenview, IL 60026-1196
Phone (773) 342-3600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1073757571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 HALINA DR E",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261196",
            "telephone_number": "773-342-3600",
            "fax_number": "773-342-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223565",
            "telephone_number": "773-342-3600",
            "fax_number": "773-342-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALYAN SANDESARA MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "SANDESARA",
        "authorized_official_first_name": "KALYAN",
        "authorized_official_title_or_position": "PRESIDENT OF  THE CORPORATION",
        "authorized_official_telephone_number": "773-342-3600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036065899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.