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General NPI Number Information
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NPI Number | 1457567539
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Entity Type | Organization
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Legal Business Name | KIRKOR VAHE KARACHORLU MD LTD
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 326 W 64TH ST
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City | CHICAGO
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State | IL
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Zip | 60621-3114
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Country | US
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Telephone | 773-962-4428
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2910
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-2910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIRKOR V KARACHORLU
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Credential | MD
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Telephone | 773-962-4428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 036044607
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License Number State | IL
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