Provider Demographics
NPI:1821237199
Name:MDRX MEDICAL PC
Entity type:Organization
Organization Name:MDRX MEDICAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-404-2463
Mailing Address - Street 1:17732 OAK PARK AVE STE E-F
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-3934
Mailing Address - Country:US
Mailing Address - Phone:708-404-2463
Mailing Address - Fax:
Practice Address - Street 1:17732 OAK PARK AVE STE E-F
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-3934
Practice Address - Country:US
Practice Address - Phone:708-404-2463
Practice Address - Fax:708-755-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036085688Medicaid
IL036085688Medicaid
F58846Medicare UPIN