MISS AMALA CHACKO (NPI# 1770105611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770105611 |
| Entity Type | Individual |
| Full Name | MISS AMALA CHACKO |
| Credential | MD |
| Practice Address |
3722 South Harlem Ave Macneal Center for Internal Medicine Riverside IL 60546 |
| Mailing Address |
3249 S Oak Park Ave Macneal Hospital Berwyn IL 60402 |
| Practice Telephone | 7087836566 |
| Practice Fax Number | 7087836567 |
| Mailing Telephone | 7087833401 |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 125076606 | IL | Allopathic & Osteopathic Physicians |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3722 SOUTH HARLEM AVE MACNEAL CENTER FOR INTERNAL MEDICINE |
| City | RIVERSIDE |
| State | IL |
| Zip Code | 60546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700598 | Bekim Koleci | Pharmacist | 2500 South Harlem Ave, North Riverside, North Riverside, IL 60546 | 2020-11-02 |
| 1073136495 | Lydia Alejandra Robles Gomez | Internal Medicine | 3722 S Harlem Ave, Macneal Center for Internal Medi, Suite Ll 34, Riverside, IL 60546 | 2020-05-20 |
| 1982225173 | Aneurin Cornolius Fernandez | Internal Medicine | 3722 South Harlem Ave Suite Ll34, Macneal Center for Internal Medicine, Riverside, IL 60546 | 2020-04-29 |
| 1477113264 | Amulya Reddy Kasireddy | Internal Medicine | 3722 South Harlem Macneal Center for Internal Meidicine, Suite Ll34, Riverside, IL 60546 | 2019-06-14 |
| 1336702927 | Shelden Selas Rodrigues | Internal Medicine | Macneal Center for Internal Medicine 3722 South Harlem, Suite Ll34, Riverside, IL 60546 | 2019-04-18 |
| 1083277685 | Hasrat Sidhu | Internal Medicine | 3722 South Harlem Ave., Macneal Center for Internal Med, Suite Ll34, Riverside, IL 60546 | 2019-04-18 |
| 1972073559 | Patricia Dumke | Physical Therapist | 2518 S. Harlem Unit C, North Riverside, IL 60546 | 2018-11-27 |
| 1336639426 | Daniele Sebastiano Restifo Ortega | Internal Medicine | Macneal Center for Internal Medicine, 3722 South Harlem Ave Suite Ll34, Riverside, IL 60546 | 2018-05-14 |
| 1699263632 | Diana Alexandra Kreppel | Internal Medicine | 3722 South Harlem Avenue Macneal Center for Internal Me, Suite Ll34, Riverside, IL 60546 | 2018-04-25 |
| 1205333663 | Swathi Sathyanarayana Rao | Student in an Organized Health Care Education/Training Program | 3722 S. Harlem Ave. Macneal Center for Internal Medicin, Suite Ll34, Riverside, IL 60546 | 2018-04-11 |
| Find all providers in zip 60546 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447870365 | Monica Sameh Hanna | Student in an Organized Health Care Education/Training Program | University of California Riverside School of Medicine, 14350 Meridian Pkwy # 2, Riverside, CA 92518-3035 | 2020-04-21 |
| 1861011876 | Monika Ellyn Garcia | Student in an Organized Health Care Education/Training Program | 14350 Meridian Parkway Box #2, Riverside, CA 92518 | 2020-04-09 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1114553765 | Pamela Picchi | Student in an Organized Health Care Education/Training Program | 111 Prescott Ave, Riverside, RI 02915-1944 | 2020-03-16 |
| 1538794094 | Jason Washington | Student in an Organized Health Care Education/Training Program | 4301 La Sierra Ave Apt 50, Riverside, CA 92505-2906 | 2020-03-05 |
| 1144860404 | Brian Jisu Shin | Student in an Organized Health Care Education/Training Program | 8293 Perla Dr, Riverside, CA 92504-2419 | 2020-01-14 |
| 1609415116 | Broderich Alexander Durley | Student in an Organized Health Care Education/Training Program | 14235 Oakley Dr, Riverside, CA 92503-7236 | 2019-12-31 |
| 1861031353 | Alex Tovar | Student in an Organized Health Care Education/Training Program | 16901 Clementine Ct, Riverside, CA 92503-6935 | 2019-12-31 |
| 1477192979 | Gregory David White | Student in an Organized Health Care Education/Training Program | 7965 Los Arboles Pl, Riverside, CA 92504-3530 | 2019-12-31 |
| 1407497076 | Guadalupe Rocha | Student in an Organized Health Care Education/Training Program | 10135 Hillsborough Ln, Riverside, CA 92503-1018 | 2019-10-03 |
| Find all providers in RIVERSIDE | ||||
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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.