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Dr. Juan Chediak, MD
Specialist in Chicago, Illinois
NPI 1720098361

Juan Chediak is a Specialist based in Chicago, IL. Juan Chediak practices in Chicago, IL and has the professional credentials of MD. The NPI Number for Juan Chediak is 1720098361 and holds a License No. 036-048665 (Illinois).

The current practice location address for Juan Chediak is 3000 N Halsted St, Chicago, IL and can be reached out via phone at 773-296-7089 and via fax at 773-296-7731.

Location: 3000 N Halsted St, Chicago, IL, 60657-5188
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720098361
Provider Name
Juan Chediak
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3000 N Halsted St, Chicago, IL, 60657-5188
Phone Number
773-296-7089
Fax Number
773-296-7731
Provider Enumeration Date
08/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
213425 01 IL MEDICARE
363965106 01 IL BCBS
036048665 05 IL
institution
Provider Business Practice Location Address Details
Address
3000 N Halsted St
City
Chicago
State
Illinois
Zip
60657-5188
Phone Number
773-296-7089
Fax Number
773-296-7731
person
Provider Business Mailing Address Details
Address
3000 N Halsted St
City
Chicago
State
Illinois
Zip
60657-5188
Phone Number
773-296-7089
Fax Number
773-296-7731
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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