Individual provider Active NPI

Chrisantha Ernest Anandappa, M.D.

  • Psychiatry Physician
  • Evanston, IL
National Provider Identifier
1154582385
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.132734 Issued in IL
Practice address
1007 Church St Ste 312
Evanston, IL 60201-5912
Phone
(844) 215-4468
Fax
(877) 428-7891
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 036.132734 IL Primary
Psychiatry Physician 2084P0800X 4301092315 MI

Addresses

Primary practice location

1007 Church St Ste 312
Evanston, IL 60201-5912

Mailing address

702 Asbury Ave
Evanston, IL 60202-2135
Phone (708) 557-1930

Other practice location 1

1535 Lake Cook Rd Ste 110
Northbrook, IL 60062-1450
Phone (866) 729-1012 ext. 1035

Other practice location 2

702 Asbury Ave
Evanston, IL 60202-2135
Phone (708) 557-1930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Feb 28, 2018 through Feb 29, 2028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chrisantha E Anandappa MD Current Accepting new patients
Chrisantha Anandappa MD Current Accepting new patients

Locations

2500 W Bradley Pl
Ste 100
Chicago, IL 60618
Phone (224) 306-1879

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.chrisanthaanandappa@146897.advancedmd-direct.com

Organizations & group practices 2

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1154582385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 ASBURY AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022135",
            "telephone_number": "708-557-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 CHURCH ST STE 312",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015912",
            "telephone_number": "844-215-4468",
            "fax_number": "877-428-7891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 Lake Cook Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600621450",
            "country_code": "US",
            "telephone_number": "866-729-1012 x1035",
            "fax_number": "847-919-6871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 Asbury Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602022135",
            "country_code": "US",
            "telephone_number": "708-557-1930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANANDAPPA",
        "first_name": "CHRISANTHA",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.132734",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301092315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.