Provider Demographics
NPI:1639189285
Name:CHANDARANA, PARAGINI K (MD)
Entity Type:Individual
Prefix:DR
First Name:PARAGINI
Middle Name:K
Last Name:CHANDARANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21540 W EMPRESS LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-6316
Mailing Address - Country:US
Mailing Address - Phone:708-313-6878
Mailing Address - Fax:708-887-5532
Practice Address - Street 1:15505 E 127TH ST
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-4433
Practice Address - Country:US
Practice Address - Phone:708-313-6878
Practice Address - Fax:708-887-5532
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-046440174400000X
IL0360464402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD12467Medicare UPIN