Healthcare Provider Details

I. General information

NPI: 1275551137
Provider Name (Legal Business Name): TODD JAY OCHS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 W WILSON AVE
CHICAGO IL
60640-5255
US

IV. Provider business mailing address

1945 W WILSON AVE
CHICAGO IL
60640-5255
US

V. Phone/Fax

Practice location:
  • Phone: 773-769-4600
  • Fax: 773-769-6242
Mailing address:
  • Phone: 773-769-4600
  • Fax: 773-769-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: