MEDICARE: DR. UMESH CHANDER RAO CHAKUNTA 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	2084P0800X	Psychiatry Physician	036.165281	IL
2	2084P0800X	Psychiatry Physician	39233	IA

General Provider Information

NPI Number	:	1528252210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. UMESH CHANDER RAO CHAKUNTA M.D.

Provider Business Mailing Address
First Line	:	3008 HAPPY LANDING DR
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-6259
Country	:	US
Telephone Number	:	331-529-8136
Fax Number	:	877-428-7891

Provider Business Practice Location Address
First Line	:	3008 HAPPY LANDING DR
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-6259
Country	:	US
Telephone Number	:	331-529-8205
Fax Number	:	877-428-7891

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

Provider Enumeration Date	:	09/05/2007
Last Update Date	:	08/25/2023

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