Provider Demographics
NPI:1841160017
Name:CHACKO, BALU K
Entity type:Individual
Prefix:
First Name:BALU
Middle Name:K
Last Name:CHACKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 DEER TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-5040
Mailing Address - Country:US
Mailing Address - Phone:205-492-6000
Mailing Address - Fax:
Practice Address - Street 1:2401 HASSELL RD STE 1510
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7241
Practice Address - Country:US
Practice Address - Phone:847-781-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-11
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0901XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management, Diplomate