Provider Demographics
NPI:1508866245
Name:CHEST DISEASES ASSOCIATES PC
Entity Type:Organization
Organization Name:CHEST DISEASES ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAKAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-769-0054
Mailing Address - Street 1:8909 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7039
Mailing Address - Country:US
Mailing Address - Phone:219-769-0054
Mailing Address - Fax:219-769-1793
Practice Address - Street 1:8909 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7039
Practice Address - Country:US
Practice Address - Phone:219-769-0054
Practice Address - Fax:219-769-1793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50002847A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200011400Medicaid
IN200011400Medicaid