Provider Demographics
NPI:1447837018
Name:SALAZAR, CHASE (MD)
Entity type:Individual
Prefix:DR
First Name:CHASE
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 N RAVENSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-4510
Mailing Address - Country:US
Mailing Address - Phone:773-561-7500
Mailing Address - Fax:773-561-7612
Practice Address - Street 1:676 N SAINT CLAIR ST STE 415
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3133
Practice Address - Country:US
Practice Address - Phone:312-926-3627
Practice Address - Fax:312-694-4102
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.077710207Q00000X
IL390200000X
IL036171175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program