Provider Demographics
NPI:1902246275
Name:CHACKANAD, RONIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:RONIA
Middle Name:A
Last Name:CHACKANAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3 ERIE CT
Mailing Address - Street 2:SUITE L700
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2519
Mailing Address - Country:US
Mailing Address - Phone:708-763-1222
Mailing Address - Fax:708-763-1471
Practice Address - Street 1:3 ERIE CT
Practice Address - Street 2:SUITE L700
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2519
Practice Address - Country:US
Practice Address - Phone:708-763-1222
Practice Address - Fax:708-763-1471
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125064177207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine