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General NPI Number Information
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NPI Number | 1295138857
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Entity Type | Organization
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Legal Business Name | A R CHAVEZ MD SC
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 20060 GOVERNORS DR SUITE 300
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1029
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Country | US
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Telephone | 708-283-7100
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Fax | 708-283-7104
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Provider Business Mailing Address
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Address Line | 20060 GOVERNORS DR SUITE 300
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1029
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Country | US
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Telephone | 708-283-7100
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Fax | 708-283-7104
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AUGUSTO CHAVEZ
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Credential | M.D.
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Telephone | 708-283-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 036049451
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License Number State | IL
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