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DR. SIJU T CHACKO M.D.

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1720017262

Individual Registrant:
DR. SIJU T CHACKO M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
9143 INDIANAPOLIS BLVD  HIGHLAND, IN 46322-2504 US
Tel: 219-972-1547  Fax: 219-972-1641

Contact information for business:
9143 INDIANAPOLIS BLVD  HIGHLAND, IN 46322-2500 US
Tel: 219-972-1547  Fax: 219-972-1641

Registration Information:
NPI: 1720017262
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
IL036101193
Y207RI0200XAllopathic & Osteopathic Physicians
Internal Medicine
IN01064885A

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
200892400IN05
036101193IL05




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