Basic Information
Provider Information
NPI: 1134300593
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHUGHTAI
FirstName: ASIM
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 120 W 22ND ST STE 200
Address2:  
City: OAK BROOK
State: IL
PostalCode: 605231563
CountryCode: US
TelephoneNumber: 6305755000
FaxNumber:  
Practice Location
Address1: 7 SIBLEY ST
Address2:  
City: HAMMOND
State: IN
PostalCode: 463201725
CountryCode: US
TelephoneNumber: 2198526121
FaxNumber: 2198526133
Other Information
ProviderEnumerationDate: 11/14/2007
LastUpdateDate: 06/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X01064618AINY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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