DR. GERALD WALTER CHODAK (NPI# 1720086903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720086903 |
| Entity Type | Individual |
| Full Name | DR. GERALD WALTER CHODAK |
| Credential | M.D. |
| Practice Address |
4646 N Marine Dr Suite A 5500 Chicago IL 60640-5759 |
| Practice Telephone | 7735645006 |
| Practice Fax Number | 7735645007 |
| Mailing Telephone | 7735645006 |
| Mailing Fax Number | 7735645007 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2012-09-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036063301 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD IL | 1623134 | 01 |
| Street Address |
4646 N MARINE DR SUITE A 5500 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-5759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407850969 | Peter A Hancock | Podiatrist | 4646 N Marine Dr, Ste C-6500, Chicago, IL 60640-5759 | 2005-06-11 |
| 1881200368 | Chandan Singh Sapkota | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-09-19 |
| 1538771316 | Ayesha Saleem | Student in an Organized Health Care Education/Training Program | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-21 |
| 1831701978 | Allina Ghimire | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-19 |
| 1154932291 | Ayomide Ireti Sotomi-foluso | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-12 |
| 1427669860 | Yadana Oo | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-10 |
| 1467062190 | Seyma Eroglu | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-07 |
| 1003426743 | Carlos Andres Rueda Mantilla | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-07 |
| 1609486968 | Ahmet Ersin Yassa | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-08-03 |
| 1861000630 | Mustafa Ali Samejo | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2020-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
| 1467878314 | Oluwarotimi Sewedo Nettey | Urology | 1524 S. Sangamon Street, Unit 403, Chicago, IL 60608 | 2014-03-14 |
| 1881957405 | Ricardo R Rios | Urology | 5600 W Addison St Ste 305, Chicago, IL 60634-4468 | 2012-06-19 |
| 1972863124 | James Wren | Urology | 675 N Saint Clair St Fl 20, Chicago, IL 60611 | 2012-05-22 |
| 1780940023 | Ryan Patrick Werntz | Urology | 5841 S Maryland Ave # 6038, Chicago, IL 60637-1447 | 2012-04-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.