JOHN A.CHANASUE M.D.LTD NPI 1700065398

NPI Information

JOHN A.CHANASUE, M.D.LTD is a medical specialty clinic center in Alton, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). JOHN A.CHANASUE, M.D.LTD NPI is 1700065398. The provider is registered as an organization entity type.

The provider's business location address is:

307 HENRY ST
STE 200
ALTON, IL
ZIP 62002-326
Phone: (618) 462-9623
Fax: (618) 462-8591

The provider's authorized official is John A Chanasue .
The authorized official title is President and has the following contact phone number (618) 462-9623.

The enumeration date for this NPI number is 10/31/2007 and was last updated on 10/31/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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