Provider Demographics
NPI:1568099091
Name:CHERONIS, CHRISOULA (MD)
Entity Type:Individual
Prefix:
First Name:CHRISOULA
Middle Name:
Last Name:CHERONIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRYSA
Other - Middle Name:
Other - Last Name:CHERONIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2500 N LAKEVIEW AVE APT 3401
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1829
Mailing Address - Country:US
Mailing Address - Phone:773-837-8385
Mailing Address - Fax:
Practice Address - Street 1:725 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1601
Practice Address - Country:US
Practice Address - Phone:650-497-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program