Provider Demographics
NPI:1275713984
Name:CHADEN SBAI MD SC
Entity Type:Organization
Organization Name:CHADEN SBAI MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:CHADEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SBAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-444-8593
Mailing Address - Street 1:DEPT 4902
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-0001
Mailing Address - Country:US
Mailing Address - Phone:708-444-8593
Mailing Address - Fax:708-444-2673
Practice Address - Street 1:6703 159TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1781
Practice Address - Country:US
Practice Address - Phone:708-444-8593
Practice Address - Fax:708-444-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH77546Medicare UPIN