Individual
KISHORE M KARAMCHANDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 EASTLAND DR, SUITE 320, BLOOMINGTON, IL 61701-3534
(309) 661-2368
(309) 662-9709
Mailing address
1505 EASTLAND DR STE 320, BLOOMINGTON, IL 61701-7912
(309) 661-2368
(309) 662-9709
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036093871
IL
207RP1001X
Pulmonary Disease Physician
MED-PHYS-LIC-92329
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093871
—
IL
01
—
833120
MEDICARE GROUP #
—
Enumeration date
09/26/2005
Last updated
12/09/2025
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