Provider Demographics
NPI:1861597015
Name:CHOMKA, EVA V (MD)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:V
Last Name:CHOMKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3242 N NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4638
Mailing Address - Country:US
Mailing Address - Phone:312-401-3043
Mailing Address - Fax:
Practice Address - Street 1:66 W. OAK STREET
Practice Address - Street 2:4TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7325
Practice Address - Country:US
Practice Address - Phone:312-705-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036059560207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P13680Medicare ID - Type Unspecified
D13728Medicare UPIN