Provider Demographics
NPI:1932151651
Name:CHAPNICK, REBEKAH MAXINE (MD)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:MAXINE
Last Name:CHAPNICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:216-383-5303
Mailing Address - Fax:216-383-5309
Practice Address - Street 1:18599 LAKE SHORE BLVD
Practice Address - Street 2:STE 200
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1093
Practice Address - Country:US
Practice Address - Phone:216-383-5303
Practice Address - Fax:216-383-5309
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-085050207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH26513668Medicaid
OH26513668Medicaid