Kalyan Bhogilal Sandesara, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036065899 Issued in IL

Practice address

1008 N Western Ave
Chicago, IL 60622-3565

Phone

(773) 342-3600

NPI assigned

Dec 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kalyan Sandesara MD SC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1073757571
  NPD (past) Authorized official

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811053978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 HALINA DR E",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223565",
            "telephone_number": "773-342-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDESARA",
        "first_name": "KALYAN",
        "middle_name": "BHOGILAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036065899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065899",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Leigh Sanders, PT, DPT
• Tracie M Sanders, MS
• Victoria Roberts Sanders, M.S., C.G.C.
• William Merrick Sanders, MD
• Lindsey Sanderson
• Carmen Sandford
• Gagandeep Sandhu, DPM
• Manjit Lal Sandhu, MD
• Navdeep Sandhu, LCPC
• Sumeet Sandhu, DO

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.