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General NPI Number Information
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NPI Number | 1700055571
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Entity Type | Organization
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Legal Business Name | METROPOLITAN CHICAGO HEALTH ASSOCIATION
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 45 W 111TH ST
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City | CHICAGO
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State | IL
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Zip | 60628-4247
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Country | US
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Telephone | 773-995-3110
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Fax | 773-995-1076
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Provider Business Mailing Address
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Address Line | 45 W 111TH ST
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City | CHICAGO
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State | IL
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Zip | 60628-4247
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Country | US
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Telephone | 773-995-3110
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Fax | 773-995-1076
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | DR. JAI D ARYA
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Credential | M.D.
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Telephone | 773-995-3405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | IL
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