Individual
LAUREN CHINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6812 STATE ROUTE 162 STE 22, MARYVILLE, IL 62062-8553
(618) 391-5330
(618) 391-5331
Mailing address
6810 STATE ROUTE 162, BOX 215, MARYVILLE, IL 62062
(618) 391-6495
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
019985
NY
Other
Enumeration date
08/07/2016
Last updated
08/28/2024
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