Individual
LYDIA CHELALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036157436
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249045500
—
MD
05
—
47288601
—
DC
Enumeration date
04/30/2015
Last updated
09/27/2024
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