Healthcare Provider Details

I. General information

NPI: 1891615092
Provider Name (Legal Business Name): AERIN CHAVAKULA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N PROSPECT ST
AKRON OH
44304-1222
US

IV. Provider business mailing address

2763 MATTHEW CT
LOVELAND OH
45140-1129
US

V. Phone/Fax

Practice location:
  • Phone: 330-485-6831
  • Fax:
Mailing address:
  • Phone: 513-509-0848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: