Basic Information
| Provider Information | |||||||||
| NPI: | 1942204557 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEMAN | ||||||||
| FirstName: | CHAD | ||||||||
| MiddleName: | JUDE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ALEMAN | ||||||||
| OtherFirstName: | CHAD | ||||||||
| OtherMiddleName: | J | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2001 BUTTERFIELD RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605151050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307252730 | ||||||||
| FaxNumber: | 8442055691 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 ERNEST W BARRETT PKWY NW | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | KENNESAW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301525007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783854670 | ||||||||
| FaxNumber: | 6783854671 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 202K00000X | 056795 | GA | N | Allopathic & Osteopathic Physicians | Phlebology | 207P00000X | 35084176 | OH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 056795 | GA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 2086S0129X | 056795 | GA | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2485305 | 05 | OH | MEDICAID | 609583907H | 05 | GA | MEDICAID |