Chadwell, Jon Blake

Chadwell, Jon Blake is an individual health care provider with primary practice located at 6301 University Commons Suite 360, South Bend IN 46635-1571. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as his primary health care specialty. Chadwell, Jon Blake can be contacted via phone (574) 232-4800.

Contact Information

Primary practice address
6301 University Commons Suite 360 South Bend IN 46635-1571
Phone: (574) 232-4800
Fax: (574) 280-4810
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 01061815A Indiana
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 43615 Colorado
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 35 085143 Ohio
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 39547 Kentucky

Profile Details

NPI number 1255380903
LBN Legal business name Chadwell, Jon Blake
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255380903 NPPES
Indiana Other 01061815A INDIANA LICENSE
Indiana Other 000000485851 INDIANA LICENSE
Indiana MEDICAID 200523340A INDIANA LICENSE

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