Individual
JEANIE CHAMNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
611 S MARSHALL AVE, MC LEANSBORO, IL 62859-1213
(618) 643-2361
(186) 433-9176
Mailing address
PO BOX 429, MC LEANSBORO, IL 62859-0429
(618) 643-2361
(618) 643-3917
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002619
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047016
HEALTH ALLIANCE
—
01
—
080137051
RAILROAD MEDICARE
—
01
—
10019630
BCBS
—
05
—
148969
—
IL
01
—
334689
HEALTH LINK
—
Enumeration date
08/18/2006
Last updated
03/24/2020
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