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General NPI Number Information
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NPI Number | 1942531801
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Entity Type | Organization
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Legal Business Name | ARIEL CHAVEZ MD SC
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 05/07/2010
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Provider Practice Location Address
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Address Line | 4608 S ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60609-3251
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Country | US
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Telephone | 773-927-7573
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Fax | 773-927-7382
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Provider Business Mailing Address
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Address Line | PO BOX 597202
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City | CHICAGO
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State | IL
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Zip | 60659-7202
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Country | US
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Telephone | 773-927-7573
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Fax | 773-927-7382
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. YSABEL CHAVEZ
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Credential |
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Telephone | 773-927-7573
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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 | 036054596
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License Number State | IL
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