Provider Demographics
NPI:1487001822
Name:CHOVATIYA, RAJ JITENDRA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RAJ
Middle Name:JITENDRA
Last Name:CHOVATIYA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:676 N SAINT CLAIR ST STE 1600
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2997
Mailing Address - Country:US
Mailing Address - Phone:312-695-7970
Mailing Address - Fax:312-695-0664
Practice Address - Street 1:676 N SAINT CLAIR ST STE 1600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2997
Practice Address - Country:US
Practice Address - Phone:312-695-7970
Practice Address - Fax:312-695-0664
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036152234207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology