NPIMap

Individual provider Active NPI

Rajiv Kandala, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1376608059
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036109208 Issued in IL
Practice address
7531 S. Stony Island Ave
#164
Chicago, IL 60649-3954
Phone
(773) 947-2831
Fax
(773) 947-7500
NPI assigned
Dec 24, 2006
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036109208 IL Primary

Addresses

Primary practice location

7531 S. Stony Island Ave
#164
Chicago, IL 60649-3954

Mailing address

7531 S. Stony Island Ave
#164
Chicago, IL 60649-3954
Phone (773) 947-2831

Other identifiers 1

IdentifierTypeStateIssuer
036109208MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040316000195 IL Practitioner - Family Practice 2062302094 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loretto HospitalGroup PAC ID 5193725893, 38 clinicians
Rajiv Kandala M D S CGroup PAC ID 0345130977, 10 clinicians

Practice addresses (Care Compare)

645 S Central Ave
Chicago, IL 60644-5059
Phone (773) 854-5567

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rajiv Kandala M D S C Family Medicine CurrentSince Oct 1, 2003 Accepting new patients
Loretto Hospital Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Friedell Clinic, S. C. Family Medicine CurrentSince Mar 4, 2021 Accepting new patients
Loretto Hospital CurrentSince Dec 1, 2022 Accepting new patients
Jackson Park Hospital Foundation Current Accepting new patients
Sun Med Lab LLC Family Medicine Current Accepting new patients
Moving Up Foundation, Inc. Family Medicine PastSince Jul 25, 2005 Accepting new patients
Emergency Medical Specialist, S.C Past Accepting new patients
Passages Hospice, LLC PastSince Feb 27, 2013 Accepting new patients
A Plus Extended Therapy Inc PastSince Apr 1, 2011 Accepting new patients
Southside Primary Care Group SC Family Medicine PastSince Feb 11, 2024 Accepting new patients
Rehab Services Roosevelt, S.C. Family Medicine Past Accepting new patients
Emergency Medical Specialists, II, S.C. Past Accepting new patients
Rehab Services Stoney Island, S.C. Family Medicine Past Accepting new patients
Loretto Hospital Past Accepting new patients
Toh Inc PastSince Feb 21, 2000 Accepting new patients
A Plus Home Health Care Inc. PastSince Oct 1, 2009 Accepting new patients

Locations

1625 E 75th St
Chicago, IL 60649
Phone (773) 947-2484

190 E Delaware Pl
Chicago, IL 60611
Phone (312) 944-0063

255 W 69th St
Chicago, IL 60621
Phone (773) 224-5900

645 S Central Ave
Chicago, IL 60644
Phone (773) 626-4300

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

7531 S Stony Island Ave
#164
Chicago, IL 60649
Phone (773) 947-2831

7531 S Stony Island Ave
Ste 164
Chicago, IL 60649
Phone (773) 947-2831

Interoperability endpoints

  • Direct secure messaging: rajiv.kandala.1@18552.direct.athenahealth.com
  • Direct secure messaging: rajivkandala@jph.medalliesdirect.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Berkley Nursing and Rehabilitation Center LLCOak Park, IL, CCN 146013 Skilled nursing facility Adp of the SNF Jan 13, 2026
Capital Hospice & Palliative Care LLCOakbrook Terrace, IL, CCN 141661 Hospice Corporate Director Mar 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1166918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1376608059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 S. STONY ISLAND AVE",
            "address_2": "#164",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-2831",
            "fax_number": "773-947-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S. STONY ISLAND AVE",
            "address_2": "#164",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-2831",
            "fax_number": "773-947-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDALA",
        "first_name": "RAJIV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-24",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036109208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109208",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.