Individual
JULIAN S. CHESTNUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
875 NIGHT OWL LN, ROSCOE, IL 61073-7460
(815) 623-3756
Mailing address
875 NIGHT OWL LN, ROSCOE, IL 61073-7460
(815) 623-3756
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036-066070
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036066070
—
IL
Enumeration date
08/17/2006
Last updated
07/08/2007
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