Individual
DR. JUAN CHEDIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 N HALSTED ST, SUITE 600, CHICAGO, IL 60657-5188
(773) 296-7089
(773) 296-7731
Mailing address
3000 N HALSTED ST, SUITE 600, CHICAGO, IL 60657-5188
(773) 868-0380
(773) 868-0382
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036-048665
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036048665
—
IL
01
—
213425
MEDICARE
IL
01
—
363965106
BCBS
IL
Enumeration date
08/08/2006
Last updated
09/05/2008
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