Active NPI
Gurcharan S Randhawa, MD
- Geriatric Medicine (Internal Medicine) Physician
- Chicago, IL
National Provider Identifier
1639206535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 036085519
- Practice address
- 1229 N North Branch St
Suite 210
Chicago, IL 60642-2473 - Phone
- (312) 939-5090
- Fax
- (312) 640-4496
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 27214 | IA | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 036085519 | IL | Primary |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 01038819A | IN |
Addresses
Primary practice location
1229 N North Branch St
Suite 210
Chicago, IL 60642-2473
Mailing address
1229 N North Branch St
Suite 210
Chicago, IL 60642-2473
Phone (312) 939-5090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038819A | IN | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keokuk County Health Center | Past | Accepting new patients | |
| Lake Mi Mobile Doctors P.C. | Geriatric Medicine | Past | Accepting new patients |
| Mobile Ultrasound LLC | Past | Accepting new patients | |
| Iowa Rural Surgical Associates, P.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Surgery Physician
- Oskaloosa, IA
- NPI 1275566770
-
- Rural Health Clinic/Center
- Hedrick, IA
- NPI 1588492862
-
- Geriatric Medicine (Internal Medicine) Physician
- Austin, TX
- NPI 1982962924
-
- Vascular Specialist/Technologist Cardiovascular
- Kansas City, MO
- NPI 1407113517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320105600000",
"number": "1639206535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 N NORTH BRANCH ST",
"address_2": "SUITE 210",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606422473",
"telephone_number": "312-939-5090",
"fax_number": "312-640-4496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 N NORTH BRANCH ST",
"address_2": "SUITE 210",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606422473",
"telephone_number": "312-939-5090",
"fax_number": "312-640-4496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDHAWA",
"first_name": "GURCHARAN",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2011-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IA",
"license": "27214",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "IL",
"license": "036085519",
"primary": true
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "IN",
"license": "01038819A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.