Provider Demographics
NPI: | 1881624757 |
---|---|
Name: | FRANCISCO L CHUY MD SC |
Entity type: | Organization |
Organization Name: | FRANCISCO L CHUY MD SC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICIAN PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | FRANCISCO |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | CHUY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 847-675-2141 |
Mailing Address - Street 1: | 3919 W TOUHY AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | LINCOLNWOOD |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60712 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 847-675-2141 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3919 W TOUHY AVE |
Practice Address - Street 2: | |
Practice Address - City: | LINCOLNWOOD |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60712 |
Practice Address - Country: | US |
Practice Address - Phone: | 847-675-2141 |
Practice Address - Fax: | 847-675-2142 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-04 |
Last Update Date: | 2012-10-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IL | 036087894 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |