MEDICARE: CHHAYA CHANDEL 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	208000000X	Pediatrics Physician	036092960	IL

General Provider Information

NPI Number	:	1851384200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHHAYA CHANDEL M.D

Provider Business Mailing Address
First Line	:	550 N MIDLOTHIAN RD
Second Line	:	# 400
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1613
Country	:	US
Telephone Number	:	847-837-1923
Fax Number	:	847-837-1924

Provider Business Practice Location Address
First Line	:	550 N MIDLOTHIAN RD
Second Line	:	# 400
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1613
Country	:	US
Telephone Number	:	847-837-1923
Fax Number	:	847-837-1924

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	12/10/2013

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