Individual provider Active NPI

Rajeswari Chandran, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Oak Forest, IL
National Provider Identifier
1841353174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
36088104 Issued in IL
Practice address
15900 South Cicero Ave
Oak Forest, IL 60452
Phone
(708) 633-3478
Fax
(708) 633-3449
NPI assigned
Dec 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 36088104 IL Primary

Addresses

Primary practice location

15900 South Cicero Ave
Oak Forest, IL 60452

Mailing address

15900 South Cicero Ave
Oak Forest, IL 60452
Phone (708) 633-3478

Other identifiers 1

IdentifierTypeStateIssuer
36088104MedicaidIL

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
I20070308000250 IL Practitioner - Pathology 4284737487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Anthony Health AffiliatesGroup PAC ID 1254321474, 95 clinicians

Practice addresses (Care Compare)

4177 S Archer Ave
Chicago, IL 60632-1849
Phone (773) 254-2222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36088104ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Services Illinois, LTD Anatomic Pathology & Clinical Pathology Current Accepting new patients
Mount Sinai Community Foundation Dba Sinai Medical Group CurrentSince May 29, 2016 Accepting new patients
Saint Anthony Health Affiliates CurrentSince Apr 23, 2022 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Saint Anthony Health Affiliates CurrentSince Apr 23, 2022 Accepting new patients
Mount Sinai Community Foundation CurrentSince May 29, 2016 Accepting new patients
Pathology Physician Services, LTD Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

4177 S Archer Ave
Chicago, IL 60632
Phone (773) 254-2222

1302 N Main St
Sandwich, IL 60548
Phone (815) 486-8484

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841353174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 SOUTH CICERO AVE",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "60452",
            "telephone_number": "708-633-3478",
            "fax_number": "708-633-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 SOUTH CICERO AVE",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "60452",
            "telephone_number": "708-633-3478",
            "fax_number": "708-633-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRAN",
        "first_name": "RAJESWARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "36088104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36088104",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

Verify at the official NPI Registry.