| Nirav P Chudgar Mdsc | |
|
1600 167th St Ste 200 Calumet City IL 60409-5445 | |
| (708) 832-0244 | |
| (708) 832-1008 |
| Full Name | Nirav P Chudgar Mdsc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1600 167th St Ste 200, Calumet City, Illinois |
| Authorized Official Name and Position | Nirav Pritambhai Chudgar (DIRECTOR OF CORPORATION) |
| Authorized Official Contact | 7088320244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nirav P Chudgar Mdsc 1600 167th St Ste 200 Calumet City IL 60409-5445 Ph: (708) 832-0244 | Nirav P Chudgar Mdsc 1600 167th St Ste 200 Calumet City IL 60409-5445 Ph: (708) 832-0244 |
| NPI Number | 1639132590 |
|---|---|
| Provider Enumeration Date | 04/10/2006 |
| Last Update Date | 12/19/2021 |
| Medicare PECOS PAC ID | 7214939479 |
|---|---|
| Medicare Enrollment ID | O20070201000273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639132590 | NPI | - | NPPES |
| 036096495 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01047212A (Indiana) | Secondary |
| 207R00000X | Internal Medicine | 036096495 (Illinois) | Primary |
| Provider Name | Nirav P Chudgar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780763805 PECOS PAC ID: 3577565738 Enrollment ID: I20070201000280 |
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