Individual provider Active NPI

Sandeep Chunduri, MD

  • Hematology & Oncology Physician
  • Crystal Lake, IL
National Provider Identifier
1174740435
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
36110541 Issued in IL
Practice address
525 E Congress Pkwy
Suite 300
Crystal Lake, IL 60014-6245
Phone
(815) 759-9260
Fax
(815) 459-7460
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 36110541 IL Primary

Addresses

Primary practice location

525 E Congress Pkwy
Suite 300
Crystal Lake, IL 60014-6245

Mailing address

525 E Congress Pkwy Ste 300
Crystal Lake, IL 60014-6258
Phone (815) 759-9260

Other identifiers 1

IdentifierTypeStateIssuer
1275843476OtherILGROUP NPI NUMBER

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address schunduri227338@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20101124000346 IL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3476749847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Northeastern Ohio University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

27750 W Hwy 22
Barrington, IL 60010-2379

350 Surryse Rd
Suite 100
Lake Zurich, IL 60047-3217
Phone (847) 438-2144

450 W Hwy 22
Neonatology
Barrington, IL 60010-1919
Phone (847) 381-0123

525 E Congress Pkwy
Crystal Lake, IL 60014-6258

650 W Lake Cook Rd
Buffalo Grove, IL 60089-2082
Phone (847) 459-1160

836 W Wellington
Suite G346
Chicago, IL 60657-5147
Phone (773) 296-7147

836 W Wellington Ave
Chicago, IL 60657-5147

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36110541ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Mar 2, 2019 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 2, 2019 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

525 E Congress Pkwy
Crystal Lake, IL 60014
Phone (815) 479-7490

525 E Congress Pkwy
Ste 300
Crystal Lake, IL 60014
Phone (815) 759-9260

1800 Hollister Dr
Ste 112
Libertyville, IL 60048
Phone (708) 367-6781

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1174740435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E CONGRESS PKWY STE 300",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146258",
            "telephone_number": "815-759-9260",
            "fax_number": "815-459-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E CONGRESS PKWY",
            "address_2": "SUITE 300",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146245",
            "telephone_number": "815-759-9260",
            "fax_number": "815-459-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNDURI",
        "first_name": "SANDEEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "36110541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1275843476",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schunduri227338@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "525 E Congress Pkwy",
            "address_2": "Suite 300",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "525 E Congress Pkwy",
            "address_2": "Suite 300",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.