Chandragupta S Vedak, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-070389 Issued in IL

Practice address

500 Coventry LN
Suite 205
Crystal Lake, IL 60014-7579

Phone

(815) 455-7100

Fax

(815) 455-3951

NPI assigned

Jul 20, 2005

Last updated

Dec 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

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

Specialty

Psychiatry

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rosecrance IncGroup PAC ID 3779656582, 33 clinicians

Horizons Behavioral Health LLCGroup PAC ID 4385531672, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Horizons Behavioral Health LLC

  • Social Worker
  • Crystal Lake, IL
  • NPI 1881692689
  Medicare reassignment Care Compare group NPD
• Rosecrance Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1013289446
  Medicare reassignment Care Compare group NPD
• A Safe Haven, L.L.C.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
  • NPI 1124206800
  Medicare reassignment NPD
• A Safe Haven, L.L.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1821872565
  NPD
• Rosecrance Inc

  dba Rosecrance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moline, IL
  • NPI 1639892698
  NPD
• Rosecrance, Inc.

  dba Rosecrance Harrison - CRU

  • Substance Abuse Rehabilitation Facility
  • Rockford, IL
  • NPI 1144499542
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Northern Illinois Medical Center

  dba Centegra Hospital McHenry

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1871592881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COVENTRY LN",
            "address_2": "SUITE 205",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147579",
            "telephone_number": "815-455-7100",
            "fax_number": "815-455-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COVENTRY LN",
            "address_2": "SUITE 205",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147579",
            "telephone_number": "815-455-7100",
            "fax_number": "815-455-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDAK",
        "first_name": "CHANDRAGUPTA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-070389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070389",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05619771",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cvedak235699@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 Coventry Ln",
            "address_2": "Suite 205",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600147579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "500 Coventry Ln",
            "address_2": "Suite 205",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600147579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Van Valkenburgh
• Valerie Elizabeth Vandello, PT
• Sarah Vanmoffaert, LPC
• Amy Michelle Vanroekel, MSW
• Rosalyn Vasquez
• Jorge J Velazquez
• Ramesh Babu Vemuri, M.D.
• Amelia Sage Venetos, RD
• Nicholas K Ventocilla, CRNA
• Jon Peter Verdoni, OTR

• Psychiatry Physician in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.

Verify at the official NPI Registry.