Provider Demographics
NPI:1710095823
Name:CHAMS, ALBERT N (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:N
Last Name:CHAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 W PETERSON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-6052
Mailing Address - Country:US
Mailing Address - Phone:773-283-3404
Mailing Address - Fax:773-283-3548
Practice Address - Street 1:4200 W PETERSON AVE
Practice Address - Street 2:STE 101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6074
Practice Address - Country:US
Practice Address - Phone:773-283-3404
Practice Address - Fax:773-283-3548
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL454210Medicare ID - Type Unspecified
ILD89175Medicare UPIN