Active NPI
Radhika Chang, MD
- Family Medicine Physician
- Carbondale, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036.171394
- Practice address
- 300 W Oak St Ste 200
Carbondale, IL 62901-1400 - Phone
- (618) 536-6621
- Fax
- (618) 453-1102
- NPI assigned
- Jun 14, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036.171394 | IL | Primary |
Addresses
Primary practice location
300 W Oak St Ste 200
Carbondale, IL 62901-1400
Mailing address
201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000
Other practice location 1
2553 Ken Gray Blvd
West Frankfort, IL 62896-4174
Phone (618) 932-3937
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
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 W Oak St
Carbondale, IL 62901-1400
Phone (618) 536-6621
Hospital & facility affiliations
- Memorial Hospital of Carbondale
- Herrin Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.171394 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Hospital Services | Current | Accepting new patients | |
| Southern Illinois Hospital Services | Family Medicine | Current | Accepting new patients |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Family Medicine | Current | Accepting new patients |
| Southern Illinois Hospital Services | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients |
Locations
405 W Jackson St
Carbondale, IL 62901
201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171
520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100
201 E Madison St
Ste 328
Springfield, IL 62702
2553 Ken Gray Blvd
West Frankfort, IL 62896
Phone (618) 932-2155
Interoperability endpoints
- radhikachang@siusm.allscriptsdirect.net
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Springfield, IL
- NPI 1396097960
Family Medicine
-
- General Acute Care Hospital
- Herrin, IL
- NPI 1528158573
-
- Hospitalist Physician
- Ottawa, IL
- NPI 1346480431
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1568210425
-
- Family Medicine Physician
- West Frankfort, IL
- NPI 1154408581
-
- Medicare Defined Swing Bed Hospital Unit
- Murphysboro, IL
- NPI 1639595036
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Carbondale, IL
- NPI 1093801797
-
- General Acute Care Hospital
- Herrin, IL
- NPI 1528158573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1982272183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E MADISON ST STE 328",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025131",
"telephone_number": "217-545-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W OAK ST STE 200",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629011400",
"telephone_number": "618-536-6621",
"fax_number": "618-453-1102"
}
],
"practiceLocations": [
{
"address_1": "2553 Ken Gray Blvd",
"address_purpose": "LOCATION",
"city": "West Frankfort",
"state": "IL",
"postal_code": "628964174",
"country_code": "US",
"telephone_number": "618-932-3937",
"fax_number": "618-932-2734",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHANG",
"first_name": "RADHIKA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-14",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036.171394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.