Provider Demographics
NPI:1437332418
Name:CHURYLA, ALESIA (MD)
Entity Type:Individual
Prefix:
First Name:ALESIA
Middle Name:
Last Name:CHURYLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 N WESTERN AVE BLDG E
Mailing Address - Street 2:MEDICAL SERVICES
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3726
Mailing Address - Country:US
Mailing Address - Phone:773-275-7700
Mailing Address - Fax:
Practice Address - Street 1:4025 N WESTERN AVE BLDG E
Practice Address - Street 2:MEDICAL SERVICES
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3726
Practice Address - Country:US
Practice Address - Phone:773-275-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036132796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine