Healthcare Provider Details

I. General information

NPI: 1427946318
Provider Name (Legal Business Name): KATHERINE ROSE CHANDLER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 W HARRISON ST
CHICAGO IL
60612-3801
US

IV. Provider business mailing address

2114 W LYNDALE ST APT 2R
CHICAGO IL
60647-3390
US

V. Phone/Fax

Practice location:
  • Phone: 312-947-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number209032769
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: