Individual
DR. MICHAEL A. CHIPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
(618) 457-0469
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
005202
AZ
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
036.133110
IL
207P00000X
Emergency Medicine Physician
005202
AZ
207P00000X
Emergency Medicine Physician
Primary
036.133110
IL
207P00000X
Emergency Medicine Physician
036133110
IL
207P00000X
Emergency Medicine Physician
2246
ME
390200000X
Student in an Organized Health Care Education/Training Program
R1028
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005202
MEDICAL LICENSE
AZ
05
—
1760693899
—
ME
Enumeration date
05/24/2007
Last updated
02/04/2021
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