Sudarsana Chakrabarti, MD
Individual provider Active NPI Cardiovascular Disease Physician · Homer Glen, IL
NPI 1104096940 · NPPES record last updated Apr 6, 2017
Key facts
- NPI
- 1104096940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 036119041 (IL)
- Practice address
- 15750 S Bell Rd
2D
Homer Glen, IL 60491-8412 - Phone
- (708) 737-7136
- Fax
- (708) 887-5886
- NPI assigned
- Mar 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
15750 S Bell Rd
Suite 2D
Homer Glen, IL 60491-8420
Phone (708) 737-7136
Hospital & facility affiliations
- Silver Cross Home Health
- Icare Home Health
- Newsome Home Health Care & Purpose Care of Illinois - Joliet
- Lightways Hospice and Serious Illness Care
- Silver Cross Hospital and Medical Centers
- Northwestern Medicine Central Dupage Hospital
- Palos Community Hospital
- Advocate Christ Hospital & Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 404 |
| Removal of skin lesions | 24 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090203000572 | IL | Practitioner - Internal Medicine | 5991869190 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036119041 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suburban Wellness SC | Current |
Accepting new patients |
Locations
15750 S Bell Rd
Ste 2D
Homer Glen, IL 60491
Phone (630) 460-2136
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036119041 | IL | Yes |
Addresses
Primary practice location
15750 S Bell Rd
2D
Homer Glen, IL 60491-8412
Mailing address
113 Circle Ridge Dr
Burr Ridge, IL 60527-8380
Phone (708) 737-7136
Other providers in Homer Glen, IL
- Heather Carrero
- Susan A. Carroll
- Zaira Carvajal
- Melanie A Cerinich
- Ashley Cerullo
- Virginia Diane Chilcutt
- Chiro One Wellness Center of Homer Glen, S.C.
- Chiropractic and Acupunture Center of Homer Glen
- Julianne R Chlipala
- Angela Ciarlette
All providers in Homer Glen, IL · Cardiovascular Disease Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.