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NPI Code Detail

MEDICARE: THOMAS ALEXANDER CHIBUCOS M.S.

MEDICARE:   THOMAS ALEXANDER CHIBUCOS  M.S.
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
1235Z00000XSpeech-Language PathologistIL

General Provider Information

NPI Number : 1700921566
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS ALEXANDER CHIBUCOS M.S.
Provider Business Mailing Address
First Line : 2700 N HAMPDEN CT
Second Line : #24D
City : CHICAGO
State : IL
Zip : 60614-1869
Country : US
Telephone Number : 773-818-3491
Fax Number : 773-524-2686
Provider Business Practice Location Address
First Line : 2700 N HAMPDEN CT
Second Line : #24D
City : CHICAGO
State : IL
Zip : 60614-1869
Country : US
Telephone Number : 773-818-3491
Fax Number : 773-524-2686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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Directions to “ THOMAS ALEXANDER CHIBUCOS M.S.” Practice Location

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