Provider Demographics
NPI:1568482487
Name:CHESSARE, JOSEPH WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:CHESSARE
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 1:2000 SPRING RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1804
Mailing Address - Country:US
Mailing Address - Phone:630-472-8800
Mailing Address - Fax:630-472-9502
Practice Address - Street 1:5101 WILLOW SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2600
Practice Address - Country:US
Practice Address - Phone:708-352-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1636444OtherBCBS
ILP00312639OtherRR MEDICARE ID -WOMRI
2215114OtherBCBS PROVIDER ID
ILP00312639OtherRR MEDICARE ID -WOMRI
2215114OtherBCBS PROVIDER ID
ILL70735Medicare PIN
IL1636444OtherBCBS