Individual provider Active NPI

Surinderpal Singh Kahlon, M.D.

  • Psychiatry Physician
  • Champaign, IL
National Provider Identifier
1538265483
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036091614 Issued in IL
Practice address
206 N Randolph St Ste 2
Champaign, IL 61820-3976
Phone
(224) 786-1998
Fax
(888) 815-3583
NPI assigned
Sep 16, 2006
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036091614 IL Primary

Addresses

Primary practice location

206 N Randolph St Ste 2
Champaign, IL 61820-3976

Mailing address

3605 Bayview Dr
Danville, IL 61832-1067
Phone (217) 497-9090

Other practice location 1

550 Congressional Blvd Ste 115
Carmel, IN 46032-5644
Phone (224) 786-1998

Other practice location 2

109 W 27th St Rm 5S
New York, NY 10001-6208
Phone (224) 786-1998

Other practice location 3

4435 E Chandler Blvd Ste 200
Phoenix, AZ 85048-7651
Phone (224) 786-1998

Other practice location 4

2921 Landmark Pl Ste 215
Madison, WI 53713-4248
Phone (224) 786-1998

Other identifiers 6

IdentifierTypeStateIssuer
036091614MedicaidIL
320573OtherNYLICENSE
36137-20OtherWILICENSE
01058575AOtherINLICENSE
09232010OtherILBCBS
71253OtherAZLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY, IN, WI, AZ5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20050228000123 IL Practitioner - Psychiatry 8628021920 Reassigns benefits to 2 organizations
Practice locations: Danville, IL
I20221228001616 NY Practitioner - Psychiatry 8628021920 Reassigns benefits to 1 organization
I20230501001272 IN Practitioner - Psychiatry 8628021920 Reassigns benefits to 1 organization
I20230707001226 WI Practitioner - Psychiatry 8628021920 Reassigns benefits to 1 organization
I20240722001384 AZ Practitioner - Psychiatry 8628021920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

206 N Randolph St
2ND Floor Private Office 246
Champaign, IL 61820-3976
Phone (833) 351-8255

250 Pkwy Dr
Suite 150
Lincolnshire, IL 60069-4340
Phone (833) 351-8255

2921 Landmark PL
Suite 215
Madison, WI 53713-4248
Phone (833) 351-8255

4435 E Chandler Blvd
Suite 200
Phoenix, AZ 85048-7651
Phone (833) 351-8255

550 Congressional Blvd
Suite 115
Carmel, IN 46032-5644
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036091614ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Sep 10, 2022 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 23, 2023 Accepting new patients
Major Hospital Past Accepting new patients
Kahlon Surinderpal S PastSince Jan 1, 1990 Accepting new patients

Locations

4435 E Chandler Blvd
Ste 200
Phoenix, AZ 85048
Phone (480) 930-2322

206 N Randolph St
Ste 2
Champaign, IL 61820
Phone (540) 892-0910

250 Parkway Dr
Ste 150
Lincolnshire, IL 60069
Phone (847) 480-1346

550 Congressional Blvd
Ste 115
Carmel, IN 46032

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

2921 Landmark Pl
Ste 215
Madison, WI 53713
Phone (608) 301-5212

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1538265483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 BAYVIEW DR",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321067",
            "telephone_number": "217-497-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N RANDOLPH ST STE 2",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203976",
            "telephone_number": "224-786-1998",
            "fax_number": "888-815-3583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Congressional Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460325644",
            "country_code": "US",
            "telephone_number": "224-786-1998",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 W 27th St Rm 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100016208",
            "country_code": "US",
            "telephone_number": "224-786-1998",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4435 E Chandler Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850487651",
            "country_code": "US",
            "telephone_number": "224-786-1998",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2921 Landmark Pl Ste 215",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537134248",
            "country_code": "US",
            "telephone_number": "224-786-1998",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAHLON",
        "first_name": "SURINDERPAL",
        "middle_name": "SINGH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036091614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091614",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "320573",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "36137-20",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "01058575A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09232010",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "71253",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.