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NPI Code Detail

MEDICARE: PAUL A CHEMELLO D.O.

MEDICARE: PAUL A CHEMELLO D.O.
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
1207Q00000XFamily Medicine Physician036080191IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952499832
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL A CHEMELLO D.O.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 21160 S LAGRANGE RD
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-2010
Country : US
Telephone Number : 815-469-8806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 06/23/2022

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