Organization
IN CHARGE MEDICAL PROFESSIONALS TN,PC
Active
Parent organization
IN CHARGE MEDICAL PROFESSIONALS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IN CHARGE MEDICAL PROFESSIONALS LLC
Authorized official
MRS. JODI CZERNEJEWSKI (COO)
(262) 510-6350
Entity
Organization
Contact information
Practice address
709 WALNUT ST, CHATTANOOGA, TN 37402
(414) 312-5159
(888) 724-0875
Mailing address
2741 W LAYTON AVE STE 106, MILWAUKEE, WI 53221-2600
(414) 242-5468
(888) 724-0875
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014452
—
IN
05
—
300015506
—
IN
05
—
300015507
—
IN
05
—
300015508
—
IN
Enumeration date
07/10/2017
Last updated
09/11/2018
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