Healthcare Provider Details

I. General information

NPI: 1487941944
Provider Name (Legal Business Name): BINITA CHANDRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BINITA PRASAD

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11101 N SHERMAN RD
EDGERTON WI
53534-9002
US

IV. Provider business mailing address

11101 N SHERMAN RD
EDGERTON WI
53534-9002
US

V. Phone/Fax

Practice location:
  • Phone: 608-884-3441
  • Fax:
Mailing address:
  • Phone: 608-884-3441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberIMLC.MD.61412964
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14254-320
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036134360
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036134360
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: