# ICARE CENTER CHANDLER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831757954
- **Authorized official:** SENTHIL K RAJU MD (PROVIDER)
- **Authorized official phone:** (405) 682-8383

## Contact information

- **Practice address:** 200 PRAIRE LANE, CHANDLER, OK 74834
- **Practice address phone:** (405) 682-8383
- **Practice address fax:** (405) 265-5230
- **Mailing address:** PO BOX 610, CANUTE, OK 73626-0610
- **Mailing address phone:** (405) 682-8383
- **Mailing address fax:** (405) 265-5230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/04/2019
- **Last updated:** 08/09/2019