Organization
JOHN A.CHANASUE, M.D.LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A CHANASUE M.D. (PRESIDENT)
(618) 462-9623
Entity
Organization
Contact information
Practice address
307 HENRY ST, STE 200, ALTON, IL 62002-6326
(618) 462-9623
(618) 462-8591
Mailing address
307 HENRY ST, STE 200, ALTON, IL 62002-6326
(618) 462-9623
(618) 462-8591
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
IL
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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