Chantelois, Allen Edward

Chantelois, Allen Edward is an individual health care provider with primary practice located at 325 N Commercial St , Neenah WI 54956-2665. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Chantelois, Allen Edward can be contacted via phone (920) 722-1583.

Contact Information

Primary practice address
325 N Commercial St Neenah WI 54956-2665
Fax: (920) 722-7454
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 35128 Wisconsin

Profile Details

NPI number 1477539450
LBN Legal business name Chantelois, Allen Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2005
Last updated Jul 8th, 2007 - about 17 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 1477539450 NPPES
Wisconsin MEDICAID 32046700

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