Provider Demographics
NPI:1669472262
Name:CHUDWIN, DAVID SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:CHUDWIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-2500
Mailing Address - Country:US
Mailing Address - Phone:847-272-4296
Mailing Address - Fax:847-272-4177
Practice Address - Street 1:475 BROWN BLVD
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2325
Practice Address - Country:US
Practice Address - Phone:815-933-5092
Practice Address - Fax:815-933-5494
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-064258207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C37289Medicare UPIN