Individual
CHINMAYA MODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 W 22ND ST, OAK BROOK, IL 60523-1947
(800) 238-9307
Mailing address
1089 GROTON CT, SCHAUMBURG, IL 60193-3744
(847) 660-9521
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209029609
IL
Other
Enumeration date
06/21/2024
Last updated
08/25/2025
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