Individual provider Active NPI

Sinha S Chunduri, M.D.

  • Gastroenterology Physician
  • Melrose Park, IL
National Provider Identifier
1891866067
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036048105 Issued in IL
Practice address
675 W North Ave
Suite 511
Melrose Park, IL 60160
Phone
(708) 343-2235
Fax
(708) 343-2250
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036048105 IL Primary

Addresses

Primary practice location

675 W North Ave
Suite 511
Melrose Park, IL 60160

Mailing address

675 W North Ave
Suite 511
Melrose Park, IL 60160
Phone (708) 343-2235

Other identifiers 1

IdentifierTypeStateIssuer
036048105MedicaidIL

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
I20080329000080 IL Practitioner - Gastroenterology 4082790159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

675 W N Ave
Suite 511
Melrose Park, IL 60160-1636
Phone (708) 343-2235

Hospital & facility affiliations

  • Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy96
Upper gastrointestinal (GI) endoscopy for acid reflux47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036048105ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinha S Chunduri M.DS.C Gastroenterology CurrentSince Jan 1, 1989 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

1111 Superior St
Ste 406
Melrose Park, IL 60160
Phone (708) 343-2235

675 W North Ave
Ste 511
Melrose Park, IL 60160
Phone (708) 343-2235

Interoperability endpoints

  • Direct secure messaging: schunduri50694@direct.luhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1891866067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE 511",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "60160",
            "telephone_number": "708-343-2235",
            "fax_number": "708-343-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE 511",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "60160",
            "telephone_number": "708-343-2235",
            "fax_number": "708-343-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNDURI",
        "first_name": "SINHA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036048105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048105",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.