Individual
MS. CHAUNA YVETTE PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 LONGVIEW DR, BELLEVILLE, IL 62223-4101
(618) 580-2584
(618) 551-3005
Mailing address
333 LONGVIEW DR, BELLEVILLE, IL 62223-4101
(618) 580-2584
(618) 551-3005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891230744
NPI
—
Enumeration date
05/23/2017
Last updated
05/29/2020
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