Individual
JUSTIN CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5375
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5375
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036162304
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2022
Last updated
07/25/2025
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