Alston, Charles Clifford

Alston, Charles Clifford is an sole proprietor health care provider with primary practice located at 2017 W 95Th St Chicago, Chicago IL 60643-1115. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Alston, Charles Clifford can be contacted via phone (773) 779-2800.

Contact Information

Primary practice address
2017 W 95Th St Chicago Chicago IL 60643-1115
Phone: (773) 779-2800
Fax: (773) 779-0556
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036061393 Illinois
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036061393 Illinois

Profile Details

NPI number 1922070382
LBN Legal business name Alston, Charles Clifford
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2006
Last updated Nov 6th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922070382 NPPES
Illinois MEDICAID 036061393
Illinois Other 363472580
Illinois Other 21609820

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