Provider Demographics
NPI:1699733188
Name:CHIAO, GENE Z (MD)
Entity type:Individual
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First Name:GENE
Middle Name:Z
Last Name:CHIAO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1777 GREEN BAY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3297
Mailing Address - Country:US
Mailing Address - Phone:847-433-3460
Mailing Address - Fax:847-433-4062
Practice Address - Street 1:1777 GREEN BAY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3297
Practice Address - Country:US
Practice Address - Phone:847-433-3460
Practice Address - Fax:847-433-4062
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-12-08
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Provider Licenses
StateLicense IDTaxonomies
IL036-079891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF69553Medicare UPIN