Active NPI
Ritu Chandan, D.O.
- Family Medicine Physician
- Bourbonnais, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036098184
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036098184 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
- Riverside Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036098184 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Health System | Current | Accepting new patients | |
| Riverside Health System | Current | 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
- 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.
-
- Psychiatry Physician
- Kankakee, IL
- NPI 1336354430
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Peotone, IL
- NPI 1740346451
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.