Provider Demographics
NPI:1982679668
Name:CHRABOT, CYRIL M (MD)
Entity Type:Individual
Prefix:
First Name:CYRIL
Middle Name:M
Last Name:CHRABOT
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 1:6925 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638
Mailing Address - Country:US
Mailing Address - Phone:773-586-2099
Mailing Address - Fax:773-586-8089
Practice Address - Street 1:6925 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638
Practice Address - Country:US
Practice Address - Phone:773-586-2099
Practice Address - Fax:773-586-8089
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0021629442OtherBC/BS
C45484Medicare UPIN
ILDG8574Medicare PIN
IL211604Medicare PIN