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NPI Code Detail

MEDICARE: MR. CHIRANTAN MUKHOPADHYAY MD

MEDICARE: MR. CHIRANTAN MUKHOPADHYAY 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
1207W00000XOphthalmology Physician036133664IL
2207W00000XOphthalmology Physician60876WI

General Provider Information

NPI Number : 1922237700
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHIRANTAN MUKHOPADHYAY MD
Provider Business Mailing Address
First Line : 2650 RIDGE AVE STE 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-570-2040
Fax Number :
Provider Business Practice Location Address
First Line : 9650 GROSS POINT RD STE 1900
Second Line :
City : SKOKIE
State : IL
Zip : 60076-5006
Country : US
Telephone Number : 224-251-2020
Fax Number : 224-251-2010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2009
Last Update Date : 05/04/2026

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