Individual
PRIYANKA CHAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 GREEN BAY RD, NORTH CHICAGO, IL 60064-3037
(847) 578-8711
(847) 578-3321
Mailing address
3333 GREEN BAY RD, NORTH CHICAGO, IL 60064-3037
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
125062131
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125062131
TEMPORARY PHYSICIAN LICENSE
IL
Enumeration date
06/27/2012
Last updated
03/25/2015
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