MEDICARE: CHIBUCOS AND ASSOCIATES INC.

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	235Z00000X	Speech-Language Pathologist		IL

General Provider Information

NPI Number	:	1942345707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIBUCOS AND ASSOCIATES INC.

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	:	PRESIDENT
Name	:	THOMAS ALEXANDER CHIBUCOS
Credential	:	M.S.
Telephone Number	:	773-818-3491

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	08/22/2020

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