Organization
CHICAGO HEIGHTS MEDICAL CONSULTANTS S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAMPEN CHARO MD (PHYSICIAN)
(708) 756-1000
Entity
Organization
Contact information
Practice address
1423 CHICAGO RD, CHICAGO HEIGHTS, IL 60411-3400
(708) 799-8440
Mailing address
PO BOX 195, SCHERERVILLE, IN 46375-0975
(708) 756-1000
(708) 756-6748
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036046854
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010025527
RAILROAD MEDICARE
—
01
—
01616205
BLUE SHIELD
IL
05
—
036046854
—
IL
Enumeration date
05/30/2007
Last updated
08/04/2009
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