MEDICARE: DR. CHAITANYA CHEKKILLA MD

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	390200000X	Student in an Organized Health Care Education/Training Program	4301092318	MI
2	207Q00000X	Family Medicine Physician	01069637A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01539670	OTHER	IN	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942465802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAITANYA CHEKKILLA MD

Provider Business Mailing Address
First Line	:	6626 E. 75TH STREET
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8920 SOUTHPOINTE DRIVE
Second Line	:	SUITE B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-7505
Country	:	US
Telephone Number	:	317-497-1900
Fax Number	:	317-497-1919

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	11/27/2023

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Directions to “ DR. CHAITANYA CHEKKILLA MD” Practice Location

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