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General NPI Number Information
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NPI Number | 1568844827
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Entity Type | Individual
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Provider Name | MARY FRANCINE PANTOJA CHUA M.D., M.B.A.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1801 S HIGHLAND AVE STE L40
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City | LOMBARD
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State | IL
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Zip | 60148-4932
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Country | US
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Telephone | 630-545-4075
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Fax | 630-967-2131
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Provider Business Mailing Address
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Address Line | POB 7132960
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City | CHICAGO
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State | IL
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Zip | 60677-0001
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Country | US
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Telephone | 630-469-9200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125066865
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 036.153461
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License Number State | IL
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