Provider Demographics
NPI:1679547079
Name:CHARUK, GEORGE (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:CHARUK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1416
Mailing Address - Country:US
Mailing Address - Phone:630-947-3912
Mailing Address - Fax:404-328-7835
Practice Address - Street 1:2940 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2408
Practice Address - Country:US
Practice Address - Phone:630-366-0012
Practice Address - Fax:404-328-7835
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36083237208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1871528463OtherGROUP PROVIDER NPI #
ILK46446OtherMC INDIVIDUAL PROVIDER #
IL212193OtherMC GROUP PROVIDER #
IL1679547079OtherINDIVIDUAL NPI #
IL36083237Medicaid
IL1871528463OtherGROUP PROVIDER NPI #
ILK09704Medicare ID - Type Unspecified
IL212193OtherMC GROUP PROVIDER #