Individual
REBECCA G CHACKALACKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
UNIVERSITY OF IOWA STUDENT HEALTH SERVICE, 4189 WL, IOWA CITY, IA 52242-1100
(319) 335-8370
(319) 335-7247
Mailing address
UNIVERSITY OF IOWA STUDENT HEALTH SERVICE, 4189 WL, IOWA CITY, IA 52242-1100
(319) 335-8370
(319) 335-7247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33635
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1192815
—
IA
01
—
55711
WELLMARK BCBS
IA
Enumeration date
09/29/2005
Last updated
09/28/2007
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