Basic Information
Provider Information
NPI: 1669899316
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHANDRAN
FirstName: MEGAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SINGAL
OtherFirstName: MEGAN
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: DO
OtherLastNameType: 1
Mailing Information
Address1: 180 HARVESTER DR. STE 110
Address2:  
City: BURR RIDGE
State: IL
PostalCode: 605276686
CountryCode: US
TelephoneNumber: 7737021150
FaxNumber:  
Practice Location
Address1: 5841 S. MARYLAND AVE.
Address2: M/C 2026
City: CHICAGO
State: IL
PostalCode: 606371443
CountryCode: US
TelephoneNumber: 7738349980
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/19/2014
LastUpdateDate: 05/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2085R0202X036.143631ILY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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