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Individual

DR. SIJU T CHACKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 E 86TH PL, MERRILLVILLE, IN 46410-6258
(219) 972-1547
(219) 972-1641
Mailing address
PO BOX 10667, MERRILLVILLE, IN 46411-0667
(219) 972-1547
(219) 972-1641

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036101193
IL
207RI0200X
Infectious Disease Physician
Primary
01064885A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036101193
IL
05
200892400
IN
Enumeration date
06/30/2006
Last updated
05/23/2024
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