Provider Demographics
NPI:1922096056
Name:CHANDEL, SAMARENDRA (MD)
Entity Type:Individual
Prefix:
First Name:SAMARENDRA
Middle Name:
Last Name:CHANDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3915 OGLESBY AVE STE 1
Mailing Address - Street 2:HEART AND VASCULAR CENTER
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3358
Mailing Address - Country:US
Mailing Address - Phone:847-336-1600
Mailing Address - Fax:847-336-2380
Practice Address - Street 1:3915 OGLESBY AVE STE 1
Practice Address - Street 2:HEART AND VASCULAR CENTER
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3358
Practice Address - Country:US
Practice Address - Phone:847-336-1600
Practice Address - Fax:847-336-2380
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-097117207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease