Provider Demographics
NPI:1285839431
Name:CHILLEMI, SALVATORE (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:
Last Name:CHILLEMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 CANTON RD NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7283
Mailing Address - Country:US
Mailing Address - Phone:770-528-9788
Mailing Address - Fax:
Practice Address - Street 1:880 CANTON RD NE
Practice Address - Street 2:SUITE 400
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7283
Practice Address - Country:US
Practice Address - Phone:770-528-9788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-15839208M00000X, 207R00000X
GA070064207RN0300X
NJ25MA08786500207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine