MEDICARE: KISHORE M KARAMCHANDANI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	MED-PHYS-LIC-92329	MT
2	207RP1001X	Pulmonary Disease Physician	036093871	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	833120	OTHER		MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215923065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KISHORE M KARAMCHANDANI M.D.

Provider Business Mailing Address
First Line	:	1505 EASTLAND DR STE 320
Second Line	:
City	:	BLOOMINGTON
State	:	IL
Zip	:	61701-7912
Country	:	US
Telephone Number	:	309-661-2368
Fax Number	:	309-662-9709

Provider Business Practice Location Address
First Line	:	1505 EASTLAND DR
Second Line	:	SUITE 320
City	:	BLOOMINGTON
State	:	IL
Zip	:	61701-3534
Country	:	US
Telephone Number	:	309-661-2368
Fax Number	:	309-662-9709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	12/09/2025

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Directions to “ KISHORE M KARAMCHANDANI M.D.” Practice Location

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