Sparks, Chandler Wayne
Sparks, Chandler Wayne is an individual health care provider with primary practice located at 1512 N Green Mount Rd , O Fallon IL 62269-2083. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Sparks, Chandler Wayne can be contacted via phone (618) 624-3750.Contact Information
Primary practice address
1512 N Green Mount Rd
O Fallon IL 62269-2083
Phone: (618) 624-3750
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 2021042303 | Missouri |
Profile Details
| NPI number | 1295239747 |
|---|---|
| LBN Legal business name | Sparks, Chandler Wayne |
| Credentials | DO, MPH, MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2018 |
| Last updated | Nov 2nd, 2021 - about 3 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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