Provider Demographics
NPI:1831181619
Name:CHANDRA, RENJINI R (MD)
Entity type:Individual
Prefix:
First Name:RENJINI
Middle Name:R
Last Name:CHANDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENJINI
Other - Middle Name:
Other - Last Name:RAJEEV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7100 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1862
Mailing Address - Country:US
Mailing Address - Phone:139-141-2349
Mailing Address - Fax:913-914-5454
Practice Address - Street 1:7100 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1862
Practice Address - Country:US
Practice Address - Phone:913-914-1234
Practice Address - Fax:913-914-5454
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000160325208100000X
KS04-30917208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00231387OtherRAILROAD MEDICARE
KSP00231387OtherRAILROAD MEDICARE
H24166Medicare UPIN
KS282D785AMedicare ID - Type Unspecified