Individual
JANKI CHANDARANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3786
Mailing address
625 MOUNT AUBURN ST STE 104, CAMBRIDGE, MA 02138-4518
(174) 915-5866
(617) 661-5995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301108087
MI
207Q00000X
Family Medicine Physician
Primary
84569-20
WI
207QA0505X
Adult Medicine Physician
1014198
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922489871
—
WI
Enumeration date
06/16/2015
Last updated
12/04/2024
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