Provider Demographics
NPI:1902929383
Name:CHALAKOVA, PETYA ZHEKOVA (MD)
Entity Type:Individual
Prefix:DR
First Name:PETYA
Middle Name:ZHEKOVA
Last Name:CHALAKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:856 W NELSON ST
Mailing Address - Street 2:APT 1507
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5152
Mailing Address - Country:US
Mailing Address - Phone:312-404-6459
Mailing Address - Fax:773-348-1198
Practice Address - Street 1:836 W WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5147
Practice Address - Country:US
Practice Address - Phone:773-713-8382
Practice Address - Fax:773-296-7486
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine