Healthcare Provider Details

I. General information

NPI: 1942416235
Provider Name (Legal Business Name): SIMONA C CHIVU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 SILVER CROSS BLVD
NEW LENOX IL
60451
US

IV. Provider business mailing address

1850 SILVER CROSS BLVD
NEW LENOX IL
60451-9508
US

V. Phone/Fax

Practice location:
  • Phone: 815-300-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036128555
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: