Healthcare Provider Details

I. General information

NPI: 1477048312
Provider Name (Legal Business Name): NEIL R CHATTERJEE MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2018
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 800
CHICAGO IL
60611-2978
US

IV. Provider business mailing address

5777 DEPT
CAROL STREAM IL
60122-5777
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-4068
  • Fax: 312-695-5645
Mailing address:
  • Phone: 312-695-9797
  • Fax: 630-933-2740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036165189
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMT219043
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: