Provider Demographics
NPI:1497858310
Name:CHONKO, ARNOLD M (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:M
Last Name:CHONKO
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 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MS 3002
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6074
Mailing Address - Fax:913-588-3867
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MS 3002
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6074
Practice Address - Fax:913-588-3867
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-15931207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100195540AMedicaid
KS625440OtherFIRSTGUARD
MO05103049OtherBCBS KC
MO200980001Medicaid
C50689Medicare UPIN
MO200980001Medicaid
KS625440OtherFIRSTGUARD