Individual
DR. CHANTE THANH TRINH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
(618) 988-6186
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 942-2171
(618) 351-4917
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-110916
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
036-110916
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110916
—
IL
01
—
03932025
BCBS IL
IL
01
—
3932056
BLUE SHIELD
IL
Enumeration date
08/31/2006
Last updated
02/11/2021
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