Individual
MARIA C THACHENKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
2619 E 75TH ST, CHICAGO, IL 60649-3705
(773) 375-1900
Mailing address
1673 ASHBURY DR, LEMONT, IL 60439-8407
(630) 243-1686
(630) 243-1687
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036049708
IL
Other
Enumeration date
06/21/2006
Last updated
10/20/2015
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