| Doctor Name: | DR. EDWARD STUART CHARLIP |
| NPI Number: | 1649410325 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 036044376 |
| Business Practice Address: | 141 W Jackson Blvd Ste 2270 Chicago, IL - 606042929 |
| Business Phone Number: | 3125439983 |
| Business Fax Number: | 3123417963 |
| Mailing Address: | 141 W Jackson Blvd Ste 2270, CHICAGO |
| State: | IL |
| Postal Code: | 606042979 |
| Phone Number: | 3125439983 |
| Fax Number: | |
| NPI Enumeration Date: | 02/20/2009 |
| NPI Last Update Date: | 10/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036044376 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |