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Juan Chediak Md
Specialist in Chicago, Illinois
NPI 1477795839

Juan Chediak Md is a Specialist based in Chicago, IL. Juan Chediak Md practices in Chicago, IL. The NPI Number for Juan Chediak Md is 1477795839 and holds a License No. 036-048665 (Illinois).

The current practice location address for Juan Chediak Md is 3000 N Halsted St, Chicago, IL and can be reached out via phone at 773-868-0380 and via fax at 773-868-0382.

Location: 3000 N Halsted St, Chicago, IL, 60657-5188
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1477795839
Provider Name
Juan Chediak Md
Credential
Provider Entity Type
Organization
Address
3000 N Halsted St, Chicago, IL, 60657-5188
Phone Number
773-868-0380
Fax Number
773-868-0382
Provider Enumeration Date
04/01/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036048665 05 IL
213425 01 IL MEDICARE
363965106 01 IL BLUE CROSS BLUE SHIELD ILLINOIS
institution
Provider Business Practice Location Address Details
Address
3000 N Halsted St
City
Chicago
State
Illinois
Zip
60657-5188
Phone Number
773-868-0380
Fax Number
773-868-0382
person
Provider Business Mailing Address Details
Address
3000 N Halsted St
City
Chicago
State
Illinois
Zip
60657-5188
Phone Number
773-868-0380
Fax Number
773-868-0382
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
036-048665 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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