Individual
EDITH MERLE CHAFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6307 S STEWART AVE, SUITE 204, CHICAGO, IL 60621-3116
(773) 487-3017
(773) 487-3028
Mailing address
6307 S STEWART AVE STE 310, CHICAGO, IL 60621-3116
(773) 487-3017
(773) 487-3028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036067419
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036067419
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067419
—
IL
Enumeration date
05/19/2006
Last updated
08/21/2020
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