Provider Demographics
NPI:1326194598
Name:NITET CHARO, DPM
Entity Type:Organization
Organization Name:NITET CHARO, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NITET
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-755-7871
Mailing Address - Street 1:30 E 15TH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-3459
Mailing Address - Country:US
Mailing Address - Phone:708-755-7871
Mailing Address - Fax:708-756-3263
Practice Address - Street 1:30 E 15TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-3459
Practice Address - Country:US
Practice Address - Phone:708-755-7871
Practice Address - Fax:708-756-3263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL577630Medicare PIN
U79679Medicare UPIN