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1396051462

NPI Code Detail

MEDICARE: DR. ADRIAN CHAPA-RODRIGUEZ M.D.

MEDICARE: DR. ADRIAN CHAPA-RODRIGUEZ M.D.

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
1	208000000X	Pediatrics Physician	036.131889	IL
2	2080P0206X	Pediatric Gastroenterology Physician	300996	LA
3	2080P0206X	Pediatric Gastroenterology Physician	036.131889	IL
4	2080P0206X	Pediatric Gastroenterology Physician	01086547A	IN

General Provider Information

NPI Number	:	1396051462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIAN CHAPA-RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	11109 PARKVIEW PLAZA DR # 117
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8028 CARNEGIE BLVD STE 500
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-5788
Country	:	US
Telephone Number	:	260-266-5400
Fax Number	:	260-425-6745

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2010
Last Update Date	:	10/17/2022

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Directions to “ DR. ADRIAN CHAPA-RODRIGUEZ M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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