Dr Pablo E Chagoya, MD | |
6545 Cermak Rd, Berwyn, IL 60402-2313 | |
(708) 788-0077 | |
Not Available |
Full Name | Dr Pablo E Chagoya |
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Gender | Male |
Speciality | Pediatrics |
Location | 6545 Cermak Rd, Berwyn, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235128075 | NPI | - | NPPES |
036-112461-1 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 036112461 (Illinois) | Primary |
207PP0204X | Emergency Medicine - Pediatric Emergency Medicine | 036112461 (Illinois) | Secondary |
Entity Name | Northshore Health Centers Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114257300 PECOS PAC ID: 5799671236 Enrollment ID: O20040827000220 |
Mailing Address | Practice Location Address |
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Dr Pablo E Chagoya, MD 6545 Cermak Rd, Berwyn, IL 60402-2313 Ph: (708) 788-0077 | Dr Pablo E Chagoya, MD 6545 Cermak Rd, Berwyn, IL 60402-2313 Ph: (708) 788-0077 |
Lori J Weiss, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 6840 Windsor Ave, Berwyn, IL 60402 Phone: 708-484-0042 Fax: 708-749-5489 | |
Reema Mohammed, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3340 Oak Park Ave Ste 201, Berwyn, IL 60402 Phone: 708-795-5502 | |
Joaquin Lopez, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6238 Cermak Rd, Berwyn, IL 60402 Phone: 708-795-5020 Fax: 708-795-5023 | |
Damayanti S Hathiwala, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3340 Oak Park Ave, Suite 201, Berwyn, IL 60402 Phone: 708-795-5502 Fax: 708-795-5516 | |
Dr. Janardhan Mydam, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-2226 | |
Dr. Joseph Torre, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-2226 |