Provider Demographics
NPI:1689863029
Name:CHUY, FRANCISCO L (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:L
Last Name:CHUY
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 1:3610 W LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-7236
Mailing Address - Country:US
Mailing Address - Phone:773-267-0055
Mailing Address - Fax:
Practice Address - Street 1:3610 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-7236
Practice Address - Country:US
Practice Address - Phone:773-267-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087894173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036087894Medicaid
ILK11273Medicare UPIN
IL036087894Medicaid
IL210110Medicare PIN
IL356231Medicare PIN