Individual provider Active NPI

Sundeep Singh Randhawa, MD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1083935134
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.133258 Issued in IL
Practice address
1431 N Claremont Ave FL 2
Chicago, IL 60622-1702
Phone
(312) 491-5237
Fax
(312) 491-5453
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036.133258 IL Primary
Psychiatry Physician 2084P0800X 4301096735 MI
Forensic Psychiatry Physician 2084F0202X 036.133258 IL
Child & Adolescent Psychiatry Physician 2084P0804X 036.133258 IL

Addresses

Primary practice location

1431 N Claremont Ave FL 2
Chicago, IL 60622-1702

Mailing address

1431 N Claremont Ave FL 2
Chicago, IL 60622-1702
Phone (312) 491-5237

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131018000745 IL Practitioner - Psychiatry 8426282898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glaser and Associates LLCGroup PAC ID 2365774718, 13 clinicians

Practice addresses (Care Compare)

1431 N Claremont
1St Floor Pavilion
Chicago, IL 60622
Phone (312) 491-5498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.133258ILMDPsychiatry Physician
4301096735MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Community Health, Inc. Current Accepting new patients
Primecare Community Health Inc CurrentSince Sep 1, 2021 Accepting new patients
Primecare Community Health, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Glaser and Associates LLC Psychiatry CurrentSince Jul 22, 2024 Accepting new patients

Locations

1431 N Claremont Ave
Chicago, IL 60622
Phone (312) 491-5498

1431 N Claremont Ave
Fl 1
Chicago, IL 60622
Phone (312) 491-5498

1431 N Claremont Ave
Fl 2
Chicago, IL 60622
Phone (312) 493-9520

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

6428 Joliet Rd
Ste 201
Countryside, IL 60525

1780 Green Bay Rd
Ste 205
Highland Park, IL 60035
Phone (877) 937-4744

Organizations & group practices 4

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1083935134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-491-5237",
            "fax_number": "312-491-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-491-5237",
            "fax_number": "312-491-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDHAWA",
        "first_name": "SUNDEEP",
        "middle_name": "SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.133258",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301096735",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "IL",
            "license": "036.133258",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.133258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.