Organization
EUGENE CHUKUDEBELU MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE CHUKUDEBELU M.D. (PRESIDENT)
(773) 723-9500
Entity
Organization
Contact information
Practice address
326 W 64TH ST, SUITE 318, CHICAGO, IL 60621-3114
(773) 723-9500
(773) 224-4403
Mailing address
8259 S SAINT LAWRENCE AVE, CHICAGO, IL 60619-5009
(773) 723-9500
(773) 224-4403
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21607396
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
10/29/2007
Last updated
10/29/2007
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