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General NPI Number Information
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NPI Number | 1215923065
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Entity Type | Individual
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Provider Name | KISHORE M KARAMCHANDANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1505 EASTLAND DR SUITE 320
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City | BLOOMINGTON
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State | IL
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Zip | 61701-3534
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Country | US
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Telephone | 309-661-2368
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Fax | 309-662-9709
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Provider Business Mailing Address
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Address Line | 1505 EASTLAND DR STE 320
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City | BLOOMINGTON
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State | IL
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Zip | 61701-7912
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Country | US
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Telephone | 309-661-2368
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Fax | 309-662-9709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MED-PHYS-LIC-92329
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 036093871
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License Number State | IL
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