Individual provider Active NPI

Naresh C Chandan, DO

  • Internal Medicine Physician
  • Kankakee, IL
National Provider Identifier
1811094550
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036090440 Issued in IL
Practice address
401 N Wall St Ste 102
Kankakee, IL 60901
Phone
(815) 928-5090
Fax
(815) 928-5079
NPI assigned
Sep 17, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Male
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
Internal Medicine Physician 207R00000X 036090440 IL Primary

Addresses

Primary practice location

401 N Wall St Ste 102
Kankakee, IL 60901

Mailing address

401 N Wall St Ste 102
Kankakee, IL 60901-2934
Phone (815) 928-5090

Other practice location 1

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914
Phone (815) 523-7020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nchandan6867@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
I20090827000637 IL Practitioner - Internal Medicine 7810041290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

401 N Wall St
Suite 102
Kankakee, IL 60901-2934
Phone (815) 928-5090

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036090440ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Sep 1, 2014 Accepting new patients
Riverside Health System Current Accepting new patients

Locations

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

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

401 N Wall St
Ste 102
Kankakee, IL 60901
Phone (815) 928-5090

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: nchandan6867@direct.riversidehealthcare.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1811094550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N WALL ST STE 102",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012934",
            "telephone_number": "815-928-5090",
            "fax_number": "815-928-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N WALL ST STE 102",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "60901",
            "telephone_number": "815-928-5090",
            "fax_number": "815-928-5079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 Larry Power Rd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Bourbonnais",
            "state": "IL",
            "postal_code": "60914",
            "country_code": "US",
            "telephone_number": "815-523-7020",
            "fax_number": "815-523-7022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANDAN",
        "first_name": "NARESH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036090440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nchandan6867@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 N Wall St Ste 102",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.