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General NPI Number Information
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NPI Number | 1316661036
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Entity Type | Organization
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Legal Business Name | CAITLIN CHANDRAN MSN, APRN-FPA, FNP-BC PLLC
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Dates
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Enumeration Date | 09/27/2022
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 102 CENTER ST
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City | GRAYSLAKE
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State | IL
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Zip | 60030-1533
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Country | US
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Telephone | 303-895-4252
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Fax |
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Provider Business Mailing Address
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Address Line | 116 WEST TRL
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City | GRAYSLAKE
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State | IL
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Zip | 60030-1555
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Country | US
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Telephone | 303-895-4252
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | CAITLIN CHANDRAN
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Credential | APRN-FPA
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Telephone | 303-895-4252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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