MEDICARE: CHEST DISEASE ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician
2	207R00000X	Internal Medicine Physician
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
4	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1578378782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHEST DISEASE ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	6707 POWERS BLVD STE 106
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44129-5463
Country	:	US
Telephone Number	:	440-886-2509
Fax Number	:	440-886-2547

Provider Business Practice Location Address
First Line	:	6707 POWERS BLVD STE 106
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44129-5463
Country	:	US
Telephone Number	:	440-886-2509
Fax Number	:	440-886-2547

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DANIEL V. ILTCHEV
Credential	:	MD
Telephone Number	:	216-904-7461

Provider Enumeration Date	:	02/13/2025
Last Update Date	:	02/13/2025

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1780359273 — MRS. ELIZABETH A TAYLOR NP
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6707 POWERS BLVD STE 106
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1922847250 — MRS. ALICIA MARIE HORNER CNP
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6820 RIDGE RD STE 204
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