Dr. Jack Robert Chulengarian
Foot & Ankle Surgery
1200 N Green Bay Rd
Waukegan
, Illinois 60085-2246
Dr. Jack Robert Chulengarian
Foot & Ankle Surgery
1200 N Green Bay Rd
Waukegan
, Illinois 60085-2246
(847) 249-3338
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Dr. Jack Robert Chulengarian
- 1200 N Green Bay Rd
- Waukegan, IL
- Zip : 60085-2246
- Phone : (847) 249-3338
Second Address
- Dr. Jack Robert Chulengarian
- 1200 N Green Bay Rd
- Waukegan, IL
- Zip : 60085-2246
- Phone : (847) 249-3338
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0103X | Foot & Ankle Surgery | 016002637 | IL |
National Provider Identifier
| NPI | 1083615371 |
|---|---|
| Provider Name | Dr. Jack Robert Chulengarian |
| First Address | Waukegan, IL 60085-2246 |
| Second Address | Waukegan, IL 60085-2246 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/08/2005 |
| Last Update Date | 25/04/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 04932042 | BCBS (01) | IL |
| 480025062 | RAILROAD MEDICARE (01) | IL |
| T36191 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.