Individual
JOHN ANTHONY CHANASUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
307 HENRY ST, STE 200, ALTON, IL 62002-6326
(618) 463-9623
(618) 462-8591
Mailing address
307 HENRY ST, STE 200, ALTON, IL 62002-6326
(618) 463-9623
(618) 462-8591
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
IL
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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