Provider Demographics
NPI:1790771434
Name:CHATSKIS, EMILY (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CHATSKIS
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 1:2592 VIOLET ST
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8033
Mailing Address - Country:US
Mailing Address - Phone:847-657-0053
Mailing Address - Fax:773-275-1910
Practice Address - Street 1:5327 N SHERIDAN RD
Practice Address - Street 2:STE D
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2531
Practice Address - Country:US
Practice Address - Phone:773-275-8042
Practice Address - Fax:773-275-1910
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
9049076OtherPHCS
01626778OtherBCBS
H01853Medicare UPIN
IL212122Medicare ID - Type Unspecified