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General NPI Number Information
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NPI Number | 1780866186
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Entity Type | Organization
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Legal Business Name | CHHABLANI AND SHERIDAN, S.C.
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 2800 S ELLIS AVE
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City | CHICAGO
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State | IL
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Zip | 60616-2907
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Country | US
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Telephone | 630-920-1601
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Fax | 630-455-1806
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Provider Business Mailing Address
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Address Line | 2800 S ELLIS AVE
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City | CHICAGO
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State | IL
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Zip | 60616-2907
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Country | US
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Telephone | 630-920-1601
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Fax | 630-455-1806
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH T. SHERIDAN
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Credential | M.D.
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Telephone | 630-920-1601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0360 29419
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License Number State |
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