Individual provider Active NPI

Chandra Bhanu Rathod, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1710073689
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
4211 N Cicero
Suite 203
Chicago, IL 60641
Phone
(773) 794-8800
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

4211 N Cicero
Suite 203
Chicago, IL 60641

Mailing address

4211 N Cicero
Suite 203
Chicago, IL 60641
Phone (773) 794-8800

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
I20110215001187 IL Practitioner - Internal Medicine 7012197577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4211 N Cicero Ave
Suite 203
Chicago, IL 60641-1650
Phone (773) 794-8800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036059328ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonia Shah M D S C Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Chandra B Rathod MDSC CurrentSince Feb 15, 2011 Accepting new patients

Locations

4211 N Cicero Ave
Ste 203
Chicago, IL 60641
Phone (773) 794-8800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710073689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 N CICERO",
            "address_2": "SUITE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60641",
            "telephone_number": "773-794-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 N CICERO",
            "address_2": "SUITE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60641",
            "telephone_number": "773-794-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHOD",
        "first_name": "CHANDRA",
        "middle_name": "BHANU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.