NPIMap

Organization Active NPI

Sandeep Chandra MD SC

  • Internal Medicine Physician
  • Burbank, IL
National Provider Identifier
1407897218
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SANDEEP CHANDRA MD SC
Practice address
7903 Lockwood Ave
Burbank, IL 60459-2115
Phone
(708) 422-9577
Fax
(708) 422-8101
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Authorized official

Name
Dr. Sandeep Chandra, M.D.NPI 1063453876
Title
President/Owner
Phone
(708) 422-9577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7903 Lockwood Ave
Burbank, IL 60459-2115

Mailing address

7903 Lockwood Ave
Burbank, IL 60459-2115
Phone (708) 422-9577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050404000162 IL Part B Supplier - Clinic/Group Practice 7719934611 Receives reassigned benefits from 8 practitioners
Practice locations: Burbank, IL

National Provider Directory

National Provider Directory

Locations

7903 Lockwood Ave
Burbank, IL 60459
Phone (708) 422-9577

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1407897218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7903 LOCKWOOD AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592115",
            "telephone_number": "708-422-9577",
            "fax_number": "708-422-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7903 LOCKWOOD AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592115",
            "telephone_number": "708-422-9577",
            "fax_number": "708-422-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDEEP CHANDRA MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "CHANDRA",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "708-422-9577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.