Provider Demographics
NPI:1083673594
Name:AMIN, CHINTAN J (MD)
Entity type:Individual
Prefix:
First Name:CHINTAN
Middle Name:J
Last Name:AMIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11725 ILLINOIS ST STE 325
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3002
Practice Address - Country:US
Practice Address - Phone:317-688-5800
Practice Address - Fax:317-688-5805
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059339207R00000X
IL0361188481207R00000X
IN01059339A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000705902OtherANTHEM PTAN
IL036118481Medicaid
IN000000678560OtherANTHEM PTAN
IN200506870Medicaid
INM400026214Medicare PIN
INI20545Medicare UPIN