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Physician Compare National (NPI:1013164391)

HEALTHCARE PROVIDER: RIDHA CHAKEER M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1013164391
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1951568724
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20120206000824
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name CHAKEER
Individual professional last name
Provider First Name RIDHA
Individual professional first name
Provider Middle Name M
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2006
Individual professional's medical school graduation year
Primary Specialty FAMILY MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 3825 HIGHLAND AVE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 2B
Group Practice or individual's line 2 address
City DOWNERS GROVE
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 605151548
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 140288
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 ADVOCATE GOOD SAMARITAN HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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