MEDICARE: SANDEEP CHANDRA MD SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1407897218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDEEP CHANDRA MD SC

Provider Business Mailing Address
First Line	:	7903 LOCKWOOD AVE
Second Line	:
City	:	BURBANK
State	:	IL
Zip	:	60459-2115
Country	:	US
Telephone Number	:	708-422-9577
Fax Number	:	708-422-8101

Provider Business Practice Location Address
First Line	:	7903 LOCKWOOD AVE
Second Line	:
City	:	BURBANK
State	:	IL
Zip	:	60459-2115
Country	:	US
Telephone Number	:	708-422-9577
Fax Number	:	708-422-8101

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. SANDEEP CHANDRA
Credential	:	M.D.
Telephone Number	:	708-422-9577

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	01/21/2011

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