MEDICARE: IOAN D CHEREGI MD SC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center		IL

General Provider Information

NPI Number	:	1588974174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IOAN D CHEREGI MD SC

Provider Business Mailing Address
First Line	:	6374 N LINCOLN AVE STE 310
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1283
Country	:	US
Telephone Number	:	773-539-7886
Fax Number	:	773-539-8160

Provider Business Practice Location Address
First Line	:	6374 N LINCOLN AVE STE 310
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1283
Country	:	US
Telephone Number	:	773-539-7886
Fax Number	:	773-539-8160

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	MR. IOAN D CHEREGI
Credential	:	MD SC
Telephone Number	:	773-539-7886

Provider Enumeration Date	:	10/15/2010
Last Update Date	:	07/21/2022

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