Provider Demographics
NPI:1932156254
Name:CHA, ANDREW R (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:R
Last Name:CHA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2525 S MICHIGAN AVE
Mailing Address - Street 2:B-390
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2333
Mailing Address - Country:US
Mailing Address - Phone:312-567-6691
Mailing Address - Fax:312-328-7702
Practice Address - Street 1:2525 S MICHIGAN AVE
Practice Address - Street 2:B-390
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2333
Practice Address - Country:US
Practice Address - Phone:312-567-6691
Practice Address - Fax:312-328-7702
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036115944207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01621679OtherBCBS
IL036115944OtherLICENSE
ILBC9620382OtherDEA