Active NPI
Bangaruswamy Chandramouli, M.D.
- Nuclear Imaging & Therapy Physician
- Chicago, IL
National Provider Identifier
1962501544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Imaging & Therapy Physician
- License
- 18999
- Practice address
- 920 S Damen Ave
Chicago, IL 60612-3730 - Phone
- (312) 569-6435
- NPI assigned
- Sep 21, 2006
- 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 |
|---|---|---|---|---|
| Nuclear Imaging & Therapy Physician | 207UN0902X | 18999 | NE | Primary |
Addresses
Primary practice location
920 S Damen Ave
Chicago, IL 60612-3730
Mailing address
1521 Fordham CT
Naperville, IL 60565-2914
Phone (630) 778-1749
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18999 | NE | MD | Nuclear Imaging & Therapy Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962501544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 FORDHAM CT",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605652914",
"telephone_number": "630-778-1749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 S DAMEN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123730",
"telephone_number": "312-569-6435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANDRAMOULI",
"first_name": "BANGARUSWAMY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207UN0902X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
"state": "NE",
"license": "18999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.