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NPI Code Detail

MEDICARE: GABRIEL MICHAEL CHIMERA DO

MEDICARE: GABRIEL MICHAEL CHIMERA DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramIL

General Provider Information

NPI Number : 1306787775
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIEL MICHAEL CHIMERA DO
Provider Business Mailing Address
First Line : 6250 DANIELS LN
Second Line :
City : OAK FOREST
State : IL
Zip : 60452-6023
Country : US
Telephone Number : 630-460-4257
Fax Number :
Provider Business Practice Location Address
First Line : 20201 CRAWFORD AVE
Second Line :
City : OLYMPIA FIELDS
State : IL
Zip : 60461-1010
Country : US
Telephone Number : 708-855-7021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2026
Last Update Date : 04/01/2026

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