Individual
DR. AJAY RAMA CHAPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
676 N SAINT CLAIR ST STE 800, CHICAGO, IL 60611-2978
(312) 695-5103
(312) 695-5645
Mailing address
676 N SAINT CLAIR ST STE 800, CHICAGO, IL 60611-2978
(312) 695-5103
(312) 695-5645
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036127186
IL
2085R0202X
Diagnostic Radiology Physician
2013025004
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689896441
—
MO
05
—
ENROLLED
—
IL
Enumeration date
05/02/2007
Last updated
09/24/2020
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