Bevan Tandon, M.D.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

2014018834 Issued in MO

Practice address

303 E Chicago Ave
Chicago, IL 60611-4296

Phone

(312) 503-8223

NPI assigned

Jan 22, 2009

Last updated

Jul 22, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1316185820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 RUSSELL BLVD APT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103510",
            "telephone_number": "757-395-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114296",
            "telephone_number": "312-503-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDON",
        "first_name": "BEVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MO",
            "license": "2014018834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Tancredi, M.D.
• Tandem Psychology LLC
• Ely Robert Tandeter
• Cornelia Yillasan Tandez, MD
• Michael Tandlich, MD
• Shashi Tandon, MD
• Aanchal Taneja
• Akshita Taneja
• Kannan Parikh Taneja, R.P.A. - C
• Sevina Taneja, PA-C

• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.