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Individual

CHIRAG DAVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
209 CROSSROADS PL, SUITE 110, MOUNT VERNON, IL 62864-6545
(618) 241-8791
(618) 241-8623
Mailing address
209 CROSSROADS PL, SUITE 110, MOUNT VERNON, IL 62864-6545
(618) 241-8791
(618) 241-8623

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036103078
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
280207
SC
05
371334126286402
IL
05
5901672
NC
Enumeration date
06/08/2006
Last updated
11/08/2024
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