Provider Demographics
NPI:1679512412
Name:CALANDRA, JOSEPH D (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:CALANDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 WAGNER RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3220
Mailing Address - Country:US
Mailing Address - Phone:847-274-7611
Mailing Address - Fax:
Practice Address - Street 1:1331 WAGNER RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3220
Practice Address - Country:US
Practice Address - Phone:847-274-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360603822085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060382Medicaid
ILP01159854OtherRRMC
ILIL7584020Medicare PIN
ILL01746Medicare PIN
ILIL7522009Medicare PIN
IL036060382Medicaid