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General NPI Number Information
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NPI Number | 1164601415
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Entity Type | Organization
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Legal Business Name | CHANDARANA MEDICAL ASSOCIATES S.C.
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 5601 S COUNTY LINE RD
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City | HINSDALE
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State | IL
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Zip | 60521-4875
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Country | US
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Telephone | 630-286-4220
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Fax | 630-286-4247
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Provider Business Mailing Address
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Address Line | 5601 S COUNTY LINE RD
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City | HINSDALE
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State | IL
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Zip | 60521-4875
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Country | US
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Telephone | 630-286-4220
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Fax | 630-286-4247
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KANTI CHANDARANA
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Credential | MD
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Telephone | 630-286-4220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | IL
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