Chacko, Siju T
Chacko, Siju T is an individual health care provider with primary practice located at 200 E 86Th Pl , Merrillville IN 46410-6258. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Chacko, Siju T can be contacted via phone (219) 972-1547.Contact Information
Primary practice address
200 E 86Th Pl
Merrillville IN 46410-6258
Phone: (219) 972-1547
Fax: (219) 972-1641
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036101193 | Illinois |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 01064885A | Indiana |
Profile Details
| NPI number | 1720017262 |
|---|---|
| LBN Legal business name | Chacko, Siju T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | May 23rd, 2024 - about 6 months 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 | 1720017262 | NPPES |
| Indiana | MEDICAID | 200892400 | |
| Indiana | MEDICAID | 036101193 |
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