DR. SANDEEP CHUNDURI (NPI# 1174740435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174740435 |
| Entity Type | Individual |
| Full Name | DR. SANDEEP CHUNDURI |
| Credential | MD |
| Practice Address |
525 E Congress Pkwy Suite 300 Crystal Lake IL 60014-6245 |
| Mailing Address |
1800 Hollister Dr Suite 112 Libertyville IL 60048-5263 |
| Practice Telephone | 8157599260 |
| Practice Fax Number | 8154597460 |
| Mailing Telephone | 8473676781 |
| Mailing Fax Number | 8473678008 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2013-06-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
36110541 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | GROUP NPI NUMBER | 1275843476 | 01 |
| Street Address |
525 E CONGRESS PKWY SUITE 300 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-6245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134121965 | Makiko Ogino-mcelligott | Physician Assistant | 525 E Congress Pkwy, 100, Crystal Lake, IL 60014-6245 | 2005-08-11 |
| 1538517198 | Crystal Lake Immediate Care Physicians Ltd. | Emergency Medicine | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6245 | 2016-05-24 |
| 1740417286 | Amanda S Lareau | Dermatology | 525 E Congress Pkwy, Derick Dermatology Suite 200, Crystal Lake, IL 60014-6245 | 2009-06-11 |
| 1235365594 | Jennee A Rommel | Dermatology | 525 E Congress Pkwy, Suite 200, Crystal Lake, IL 60014-6245 | 2009-06-01 |
| 1750393310 | Moriah Bang | Family Medicine | 525 E Congress Pkwy, Suite 250, Crystal Lake, IL 60014-6245 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194206367 | Illinois Cancer Specialists | Internal Medicine | 360 Station Dr Ste 201, Crystal Lake, IL 60014-7978 | 2018-08-27 |
| 1497148118 | Pinal Chokshi | Internal Medicine | 525 E Congress Pkwy Ste 300, Crystal Lake, IL 60014-6258 | 2015-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649831124 | Elena Vagia | Internal Medicine | 233 E Superior St Ste 1-061, Chicago, IL 60611-2913 | 2019-06-25 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1578017596 | Mercy Clinic Specialists Services-illinois LLC | Internal Medicine | 2227 Vadalabene Dr Ste 200, Maryville, IL 62062-5824 | 2016-08-08 |
| 1356793319 | Glenda Maria Delgado Ramos | Internal Medicine | 2160 S 1st Ave Ste 167, Maywood, IL 60153-3328 | 2016-07-01 |
| 1023403516 | Meghan Rebecca Steiner | Internal Medicine | 5841 S Maryland Ave # Mc-2115, Chicago, IL 60637 | 2015-04-01 |
| 1700270154 | Joseph Heng | Internal Medicine | 5841 S Maryland Ave # Mc1152, Chicago, IL 60637-1443 | 2015-03-24 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| 1003258583 | Luis David Sumoza | Internal Medicine | 1900 West Polk Suite 755, Chicago, IL 60612 | 2013-07-24 |
| 1134562150 | Nida Hussain | Internal Medicine | 305 Medical Center, Mchenry, IL 60050 | 2013-04-09 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.