Chediak, Juan

Chediak, Juan is an sole proprietor health care provider with primary practice located at 3000 N Halsted St Suite 600, Chicago IL 60657-5188. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Chediak, Juan can be contacted via phone (773) 296-7089.

Contact Information

Primary practice address
3000 N Halsted St Suite 600 Chicago IL 60657-5188
Phone: (773) 296-7089
Fax: (773) 296-7731
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036-048665 Illinois

Profile Details

NPI number 1720098361
LBN Legal business name Chediak, Juan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 8th, 2006
Last updated Sep 5th, 2008 - about 17 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 1720098361 NPPES
Illinois Other 213425 MEDICARE
Illinois Other 363965106 MEDICARE
Illinois MEDICAID 036048665 MEDICARE

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