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Individual

TSCHANGIS MEHRPUYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1225 W LAKE ST, MELROSE PARK, IL 60160-4039
(708) 681-3000
Mailing address
520 E 22ND ST, LOMBARD, IL 60148-6110
(630) 874-2542
(630) 874-2642

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036044624
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01619414
BCBS GROUP
05
036044624-3
IL
05
036044624-4
IL
Enumeration date
08/15/2005
Last updated
03/17/2009
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