MEDICARE: DR. RAKESH CHANDRA MD

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	2084P0800X	Psychiatry Physician	036093240	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	CF3444	OTHER	IL	MEDICARE RR
8	P00464595	OTHER	KY	RR MEDICARE PIN #
9	P00830780	OTHER	KY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225065220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAKESH CHANDRA MD

Provider Business Mailing Address
First Line	:	PO BOX 155
Second Line	:
City	:	CHRISTOPHER
State	:	IL
Zip	:	62822-0155
Country	:	US
Telephone Number	:	618-724-2401
Fax Number	:	618-319-1279

Provider Business Practice Location Address
First Line	:	1155 CEDAR CT
Second Line	:
City	:	CARBONDALE
State	:	IL
Zip	:	62901-5333
Country	:	US
Telephone Number	:	618-490-1045
Fax Number	:	618-319-1279

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	03/12/2026

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Directions to “ DR. RAKESH CHANDRA MD” Practice Location

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