Edith Merle Chaffin
Family Doctor Family Doctor - Geriatric Medicine
6307 S Stewart Ave Suite 204
Chicago
, Illinois 60621-3116
Edith Merle Chaffin
Family Doctor Family Doctor - Geriatric Medicine
6307 S Stewart Ave Suite 204
Chicago
, Illinois 60621-3116
(773) 487-3028
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About
Features
Specialties
- Family Doctor
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Edith Merle Chaffin
- 6307 S Stewart Ave Ste 310
- Chicago, IL
- Zip : 60621-3116
- Fax : (773) 487-3028
- Phone : (773) 487-3017
Second Address
- Edith Merle Chaffin
- 6307 S Stewart Ave Suite 204
- Chicago, IL
- Zip : 60621-3116
- Fax : (773) 487-3028
- Phone : (773) 487-3017
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | 036067419 | IL |
| N | 207QG0300X | Family Doctor - Geriatric Medicine | 036067419 | IL |
National Provider Identifier
| NPI | 1306899216 |
|---|---|
| Provider Name | Edith Merle Chaffin |
| First Address | Chicago, IL 60621-3116 |
| Second Address | Chicago, IL 60621-3116 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/05/2006 |
| Last Update Date | 21/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036067419 | (05) | IL |
| E33649 | (02) |
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.