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NPI Code Detail

MEDICARE: AFFILIATED CHICAGO PHYSICIANS

MEDICARE: AFFILIATED CHICAGO PHYSICIANS
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
1207Q00000XFamily Medicine Physician
2111N00000XChiropractor
3213E00000XPodiatrist
4207R00000XInternal Medicine Physician
5207P00000XEmergency Medicine Physician
6207V00000XObstetrics & Gynecology Physician
7171100000XAcupuncturist

General Provider Information

NPI Number : 1629015524
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFILIATED CHICAGO PHYSICIANS
Provider Business Mailing Address
First Line : 4849 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-2503
Country : US
Telephone Number : 773-237-0755
Fax Number : 773-237-0785
Provider Business Practice Location Address
First Line : 4849 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-2503
Country : US
Telephone Number : 773-237-0755
Fax Number : 773-237-0785
Authorized Official
Title or Position : OWNER
Name : DR. NASER RUSTOM
Credential : MD
Telephone Number : 773-395-9400
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/11/2025

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Directions to “AFFILIATED CHICAGO PHYSICIANS ” 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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