Provider Demographics
NPI:1508082686
Name:SINGH, CHANDRA MOHAN (OTR)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:MOHAN
Last Name:SINGH
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:CHANDRA
Other - Middle Name:MOHAN
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD, OTR
Mailing Address - Street 1:425 SAND CREEK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-1589
Mailing Address - Country:US
Mailing Address - Phone:219-926-9779
Mailing Address - Fax:
Practice Address - Street 1:425 SAND CREEK DR
Practice Address - Street 2:SUITE C
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1589
Practice Address - Country:US
Practice Address - Phone:219-926-9770
Practice Address - Fax:219-926-9889
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003457A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist