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General NPI Number Information
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NPI Number | 1043375934
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Entity Type | Organization
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Legal Business Name | CHIKARE HEALTH SERVICES INC
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 915 W CHICAGO AVE
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City | EAST CHICAGO
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State | IN
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Zip | 46312
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Country | US
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Telephone | 219-397-6000
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Fax | 219-397-6358
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Provider Business Mailing Address
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Address Line | 915 W CHICAGO AVE
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City | EAST CHICAGO
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State | IN
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Zip | 46312-3308
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Country | US
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Telephone | 219-397-6000
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Fax | 219-397-6358
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Authorized Official
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Title or Position | OWNER/MD
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Name | KANAYO K ODELUGA
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Credential | MD
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Telephone | 219-397-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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