Organization
ARIEL CHAVEZ MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YSABEL CHAVEZ (OFFICE MANAGER)
(773) 927-7573
Entity
Organization
Contact information
Practice address
4608 S ASHLAND AVE, CHICAGO, IL 60609-3251
(773) 927-7573
(773) 927-7382
Mailing address
PO BOX 597202, CHICAGO, IL 60659-7202
(773) 927-7573
(773) 927-7382
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036054596
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036054596
—
IL
01
—
21606887
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/15/2010
Last updated
05/07/2010
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