Provider Demographics
NPI:1316661036
Name:CAITLIN CHANDRAN MSN, APRN-FPA, FNP-BC PLLC
Entity type:Organization
Organization Name:CAITLIN CHANDRAN MSN, APRN-FPA, FNP-BC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-FPA
Authorized Official - Phone:303-895-4252
Mailing Address - Street 1:116 WEST TRL
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1555
Mailing Address - Country:US
Mailing Address - Phone:303-895-4252
Mailing Address - Fax:
Practice Address - Street 1:102 CENTER ST
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1533
Practice Address - Country:US
Practice Address - Phone:303-895-4252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care