Provider Demographics
NPI:1710086848
Name:CHACON-HORN, MARIA FERNANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:FERNANDA
Last Name:CHACON-HORN
Suffix:
Gender:F
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 OGDEN AVE
Mailing Address - Street 2:EMERGENCY ROOM
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7222
Mailing Address - Country:US
Mailing Address - Phone:630-898-5275
Mailing Address - Fax:630-898-4187
Practice Address - Street 1:2000 OGDEN AVE
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7222
Practice Address - Country:US
Practice Address - Phone:630-898-5275
Practice Address - Fax:630-898-7418
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-107009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL97194Medicaid
ILL97194Medicaid