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General NPI Number Information
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NPI Number | 1750934584
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Entity Type | Individual
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Provider Name | SOLAB CHITRAKAR MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2019
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 612 ROXBURY RD
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City | ROCKFORD
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State | IL
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Zip | 61107-5089
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Country | US
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Telephone | 815-227-8331
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Fax |
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Provider Business Mailing Address
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Address Line | 44 WASHINGTON ST APT 704
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City | BROOKLINE
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State | MA
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Zip | 02445-7105
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Country | US
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Telephone | 872-806-3032
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 125074087
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 3013503
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.159910
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License Number State | IL
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