Individual
REBECCA CHOLST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 996-7416
Mailing address
10436 SOUTHWEST HWY # 2, CHICAGO RIDGE, IL 60415-2282
(708) 636-0700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.153426
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2017
Last updated
08/25/2020
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