Provider Demographics
NPI:1013104587
Name:ALLERGY & ASTHMA ASSOCIATES LTD
Entity type:Organization
Organization Name:ALLERGY & ASTHMA ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHUDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-272-4296
Mailing Address - Street 1:500 SKOKIE BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2856
Mailing Address - Country:US
Mailing Address - Phone:847-272-4296
Mailing Address - Fax:847-272-4177
Practice Address - Street 1:5911 NORTHWEST HWY
Practice Address - Street 2:SUITE 208
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8065
Practice Address - Country:US
Practice Address - Phone:815-455-7259
Practice Address - Fax:847-272-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL785030Medicare PIN