Active NPI
Naresh C Chandan, DO
- Internal Medicine Physician
- Kankakee, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036090440
- 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, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036090440 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Health System | Current | 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
- 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.
-
- General Practice Physician
- Kankakee, IL
- NPI 1417061193
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Bourbonnais, IL
- NPI 1811935240
-
- General Acute Care Hospital
- Kankakee, IL
- NPI 1538208210
-
- 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": "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
- 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.