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General NPI Number Information
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NPI Number | 1639454119
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Entity Type | Organization
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Legal Business Name | CHICAGOLAND ALLERGY AND ASTHMA CONSULTANTS LTD
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 6320 159TH ST SUITE A
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City | OAK FOREST
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State | IL
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Zip | 60452-2776
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Country | US
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Telephone | 708-687-3855
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Fax | 708-444-2324
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Provider Business Mailing Address
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Address Line | 6320 159TH ST SUITE A
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City | OAK FOREST
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State | IL
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Zip | 60452-2776
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Country | US
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Telephone | 708-687-3855
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Fax | 708-444-2324
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Authorized Official
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Title or Position | OWNER
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Name | NIRMALA M RAY
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Credential | MD
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Telephone | 708-687-3855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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