Provider Demographics
NPI:1861456022
Name:CHAROUS, STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:CHAROUS
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 1:3633 W LAKE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5805
Mailing Address - Country:US
Mailing Address - Phone:847-729-9122
Mailing Address - Fax:847-729-9134
Practice Address - Street 1:3633 W LAKE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5805
Practice Address - Country:US
Practice Address - Phone:847-729-9122
Practice Address - Fax:847-729-9134
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084409207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01615422OtherBLUECROSS BLUE SHIELD
040012421OtherRAILROAD MEDICARE
IL036084409Medicaid
604520Medicare ID - Type Unspecified
IL214592Medicare PIN
IL036084409Medicaid