Provider Demographics
NPI:1053573840
Name:DONALD L CHATMAN MD LTD
Entity type:Organization
Organization Name:DONALD L CHATMAN MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB GYNE
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LEVERETT
Authorized Official - Last Name:CHATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-220-9255
Mailing Address - Street 1:111 N WABASH AVENUE
Mailing Address - Street 2:SUITE 1210
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3092
Mailing Address - Country:US
Mailing Address - Phone:312-220-9255
Mailing Address - Fax:312-220-9245
Practice Address - Street 1:111 N WABASH AVENUE
Practice Address - Street 2:SUITE 1210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3092
Practice Address - Country:US
Practice Address - Phone:312-220-9255
Practice Address - Fax:312-220-9245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036039217174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036039217Medicaid
ILC41308Medicare UPIN
IL036039217Medicaid