Chandana Dash, OTR

Individual provider Active NPI Occupational Therapist · Du Quoin, IL

NPI 1801957337 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1801957337
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
Practice address
101 E Main St
Du Quoin, IL 62832-1422
Phone
(618) 542-8950
Fax
(618) 542-8746
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Therapeutic Group (2 clinicians)

Practice addresses (Care Compare)

1110 Cedar CT
Carbondale, IL 62901-5300
Phone (618) 529-4360

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100 (group)
Quality
80
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051109000328 IL Practitioner - Occupational Therapist in Private Practice 7719905918 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
056.006981ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Therapeutic Group Occupational Therapist Current
since Sep 30, 2005
Accepting new patients

Locations

1110 Cedar Ct
Carbondale, IL 62901
Phone (618) 457-4144

101 E Main St
Du Quoin, IL 62832
Phone (618) 542-8950

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X IL Yes

Addresses

Primary practice location

101 E Main St
Du Quoin, IL 62832-1422

Mailing address

606 Country Club LN
Carterville, IL 62918-1629
Phone (618) 542-8950

Other providers in Du Quoin, IL

All providers in Du Quoin, IL · Occupational Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.