Chacko, Ron
Chacko, Ron is an individual health care provider with primary practice located at 7000 Cermak Rd , Berwyn IL 60402-2112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Chacko, Ron can be contacted via phone (708) 484-8090.Contact Information
Primary practice address
7000 Cermak Rd
Berwyn IL 60402-2112
Phone: (708) 484-8090
Fax: (708) 445-4444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A107917 | California |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036.126315 | Illinois |
Profile Details
| NPI number | 1053527184 |
|---|---|
| LBN Legal business name | Chacko, Ron |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2007 |
| Last updated | Oct 19th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053527184 | NPPES |
| Illinois | Other | F400139202 | MEDICARE PTAN |
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