Individual provider Active NPI

Chandler Walsh

  • Hospitalist Physician
  • Oak Lawn, IL
National Provider Identifier
1699353821
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0102208447 Issued in VA
Practice address
4220 W 95TH St Ste 200
Oak Lawn, IL 60453-3072
Phone
(708) 398-0287
Fax
(708) 684-2032
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.079120 IL
Hospitalist Physician 208M00000X 0102208447 VA Primary

Addresses

Primary practice location

4220 W 95TH St Ste 200
Oak Lawn, IL 60453-3072

Mailing address

4220 W 95TH St Ste 200
Oak Lawn, IL 60453-3072
Phone (708) 398-0287

Other practice location 1

1300 E Marshall St
Richmond, VA 23298-5028
Phone (804) 282-3144

Other practice location 2

618 Hospital Rd
Tappahannock, VA 22560-5000
Phone (804) 380-0744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241111003051 VA Practitioner - Internal MedicinePractitioner - Hospitalist 8921532136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1300 E Marshall St
Richmond, VA 23298-5028
Phone (804) 828-0450

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.079120ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Sep 1, 2024 Accepting new patients

Locations

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1300 E Marshall St
Richmond, VA 23298
Phone (804) 828-3144

618 Hospital Rd
Tappahannock, VA 22560
Phone (804) 443-3311

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1699353821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 W 95TH ST STE 200",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533072",
            "telephone_number": "708-398-0287",
            "fax_number": "708-684-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W 95TH ST STE 200",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533072",
            "telephone_number": "708-398-0287",
            "fax_number": "708-684-2032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985028",
            "country_code": "US",
            "telephone_number": "804-282-3144",
            "fax_number": "804-628-7104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Tappahannock",
            "state": "VA",
            "postal_code": "225605000",
            "country_code": "US",
            "telephone_number": "804-380-0744",
            "fax_number": "804-443-6051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "CHANDLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.079120",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0102208447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.