Dr. Pablo E Chagoya
Pediatrician Pediatric Emergency Physician
6545 Cermak Rd
Berwyn
, Illinois 60402-2313
Dr. Pablo E Chagoya
Pediatrician Pediatric Emergency Physician
6545 Cermak Rd
Berwyn
, Illinois 60402-2313
(708) 788-0077
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About
Features
Specialties
- Pediatric Emergency Physician
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Pablo E Chagoya
- 6545 Cermak Rd
- Berwyn, IL
- Zip : 60402-2313
- Phone : (708) 788-0077
Second Address
- Dr. Pablo E Chagoya
- 6545 Cermak Rd
- Berwyn, IL
- Zip : 60402-2313
- Phone : (708) 788-0077
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207PP0204X | Pediatric Emergency Physician | 036112461 | IL |
| Y | 208000000X | Pediatrician | 036112461 | IL |
National Provider Identifier
| NPI | 1235128075 |
|---|---|
| Provider Name | Dr. Pablo E Chagoya |
| First Address | Berwyn, IL 60402-2313 |
| Second Address | Berwyn, IL 60402-2313 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/10/2005 |
| Last Update Date | 22/09/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036-112461-1 | (05) | IL |
| I25650 | (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.