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General NPI Number Information
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NPI Number | 1790705663
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Entity Type | Individual
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Provider Name | SANGILI CHANDRAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 9555 S. 52ND AVE.
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-634-0950
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Fax |
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Provider Business Mailing Address
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Address Line | 9555 S. 52ND AVE.
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-634-0950
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Fax |
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 036087174
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-087174
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License Number State | IL
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