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NPI Code Detail

MEDICARE: DR. PETYA ZHEKOVA CHALAKOVA MD

MEDICARE: DR. PETYA ZHEKOVA CHALAKOVA MD
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
1207R00000XInternal Medicine PhysicianIL

General Provider Information

NPI Number : 1902929383
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETYA ZHEKOVA CHALAKOVA MD
Provider Business Mailing Address
First Line : 856 W NELSON ST
Second Line : APT 1507
City : CHICAGO
State : IL
Zip : 60657-5152
Country : US
Telephone Number : 312-404-6459
Fax Number : 773-348-1198
Provider Business Practice Location Address
First Line : 836 W WELLINGTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-5147
Country : US
Telephone Number : 773-713-8382
Fax Number : 773-296-7486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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