Provider Demographics
NPI:1013164391
Name:CHAKEER, RIDHA (MD)
Entity Type:Individual
Prefix:
First Name:RIDHA
Middle Name:
Last Name:CHAKEER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9051 WILLOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-1185
Mailing Address - Country:US
Mailing Address - Phone:630-445-1022
Mailing Address - Fax:630-559-7377
Practice Address - Street 1:3825 HIGHLAND AVE STE 2B
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1548
Practice Address - Country:US
Practice Address - Phone:630-445-1022
Practice Address - Fax:630-559-7377
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036126750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1649634247Medicaid