Basic Information
| Provider Information | |||||||||
| NPI: | 1760800031 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHANDIRAMANI | ||||||||
| FirstName: | SARIKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 776351 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606773619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025889490 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 4950 NORTON HEALTHCARE BLVD STE 208 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402412847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026144179 | ||||||||
| FaxNumber: | 5026144450 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2014 | ||||||||
| LastUpdateDate: | 10/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125064574 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 036.142925 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RS0012X | 2021010211 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RS0012X | 54879 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
ID Information
| ID | Type | State | Issuer | Description | 300066562 | 05 | IN | MEDICAID | K404710 | 01 | KY | MEDICARE | OTHER |