Provider Demographics
NPI:1588870901
Name:CHAKNOS, CONSTANTINE M (MD)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:M
Last Name:CHAKNOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD.
Mailing Address - Street 2:1ST FLOOR, SUITE 300S
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2617
Mailing Address - Country:US
Mailing Address - Phone:215-662-2638
Mailing Address - Fax:215-349-5703
Practice Address - Street 1:3400 CIVIC CENTER BLVD.
Practice Address - Street 2:1ST FLOOR, SUITE 300S
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2617
Practice Address - Country:US
Practice Address - Phone:215-662-2638
Practice Address - Fax:215-349-5703
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA228780207R00000X
PAMD442952207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine