Healthcare Provider Details

I. General information

NPI: 1992156483
Provider Name (Legal Business Name): ALIN CHERAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2016
Last Update Date: 06/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S FAIRFIELD AVE F930
CHICAGO IL
60608-1782
US

IV. Provider business mailing address

530 W ARLINGTON PL 514
CHICAGO IL
60614-5995
US

V. Phone/Fax

Practice location:
  • Phone: 773-257-6464
  • Fax:
Mailing address:
  • Phone: 239-529-7680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number125.068166
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: