Provider Demographics
NPI:1366001133
Name:CHUKI NAGUANAGUA, DAGNI COROMOTO (MD)
Entity Type:Individual
Prefix:
First Name:DAGNI
Middle Name:COROMOTO
Last Name:CHUKI NAGUANAGUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1127 N OAKLEY BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3507
Mailing Address - Country:US
Mailing Address - Phone:312-770-2040
Mailing Address - Fax:312-770-3270
Practice Address - Street 1:1127 N OAKLEY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:312-770-2040
Practice Address - Fax:312-770-3270
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.158425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine