Healthcare Provider Details

I. General information

NPI: 1487215570
Provider Name (Legal Business Name): HASEEB CHAUDHARY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 CLAGUE RD STE 2480
WESTLAKE OH
44145-1585
US

IV. Provider business mailing address

960 CLAGUE RD STE 2480
WESTLAKE OH
44145-1585
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-8500
  • Fax: 440-250-2018
Mailing address:
  • Phone: 216-844-8500
  • Fax: 440-250-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number35.144450
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: