Carbondale Family Medicine,LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-107111 Issued in IL

Legal business name

CARBONDALE FAMILY MEDICINE,LLC

Practice address

1175 Cedar CT
Carbondale, IL 62901-5333

Phone

(618) 549-0300

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mukesh Chaudhry, M.D.

Title

MD

Phone

(618) 549-0300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Anup K Chaudhry, M.D.

  • Dermatology Physician
  • Carbondale, IL
  • NPI 1700843570
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1518023530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HIGH FOREST DR",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629038245",
            "telephone_number": "618-549-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015333",
            "telephone_number": "618-549-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBONDALE FAMILY MEDICINE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "CHAUDHRY",
        "authorized_official_first_name": "MUKESH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "618-549-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-107111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-107111",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Cantrell, LPN
• Carbondale Community High
• Carbondale Elem SCH Dist 95
• Carbondale Elem School
• Carbondale Family Chiropractic LLC
• Carbondale HS Distraict 165
• Carbondale Rehabilitation and Nursing Center II LLC
• Carbondale Rehabilitation and Nursing Center, LLC
• Carbondale Rural Health Clinic
• Carbondale SLF, LP

• Family Medicine Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.