Individual provider Active NPI

Ritu Chandan, D.O.

  • Family Medicine Physician
  • Bourbonnais, IL
National Provider Identifier
1710061650
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036098184 Issued in IL
Practice address
400 Riverside Dr Ste 2800
Bourbonnais, IL 60914
Phone
(815) 935-1100
Fax
(815) 937-5966
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036098184 IL Primary

Addresses

Primary practice location

400 Riverside Dr Ste 2800
Bourbonnais, IL 60914

Mailing address

400 Riverside Dr Ste 2800
Bourbonnais, IL 60914-5004
Phone (815) 935-1100

Other practice location 1

375 N Wall St
Suite P 510
Kankakee, IL 60901-3483
Phone (815) 935-1787

Other identifiers 1

IdentifierTypeStateIssuer
036098184MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rchandan6868@Direct.riversidehealthcare.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040507000167 IL Practitioner - Family Practice 5294724142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

400 Riverside Dr
Suite 2800
Bourbonnais, IL 60914-5004
Phone (815) 935-1100

Hospital & facility affiliations

  • R.M.C. Home Health Care Home health agency, Peotone, IL, CCN 147400
  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036098184ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Nov 1, 2014 Accepting new patients
Riverside Health System CurrentSince Nov 1, 2014 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

400 Riverside Dr
Ste 2800
Bourbonnais, IL 60914
Phone (815) 935-1100

720 S Crescent St
Gilman, IL 60938
Phone (815) 265-4255

375 N Wall St
Ste P510
Kankakee, IL 60901
Phone (815) 935-0750

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

401 N Wall St
Ste 208
Kankakee, IL 60901
Phone (815) 935-1161

611 S Division St
Peotone, IL 60468
Phone (708) 258-9058

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: rchandan6868@direct.riversidehealthcare.net

Organizations & group practices 3

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 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1710061650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERSIDE DR STE 2800",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145004",
            "telephone_number": "815-935-1100",
            "fax_number": "815-937-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RIVERSIDE DR STE 2800",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60914",
            "telephone_number": "815-935-1100",
            "fax_number": "815-937-5966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 N Wall St",
            "address_2": "Suite P 510",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609013483",
            "country_code": "US",
            "telephone_number": "815-935-1787",
            "fax_number": "815-935-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANDAN",
        "first_name": "RITU",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036098184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098184",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rchandan6868@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "endpointDescription": "Direct Secure Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 Riverside Dr Ste 2800",
            "city": "Bourbonnais",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.