Julian S. Chestnut, D.O.
Individual provider Active NPI Anesthesiology Physician · Roscoe, IL
NPI 1285747634 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285747634
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 036-066070 (IL)
- Practice address
- 875 Night Owl LN
Roscoe, IL 61073-7460 - Phone
- (815) 623-3756
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-066070 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Pain Management Services, LTD. | Past |
Accepting new patients | |
| Rockford Anesthesiologists Associated, L.L.C. | Anesthesiology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036-066070 | IL | Yes |
Addresses
Primary practice location
875 Night Owl LN
Roscoe, IL 61073-7460
Mailing address
875 Night Owl LN
Roscoe, IL 61073-7460
Phone (815) 623-3756
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036066070 | Medicaid | IL |
Other providers in Roscoe, IL
- Hailey Callahan
- Kimberly Christine Callahan
- Lindsay Callahan
- Maureen M Callahan
- Janet Casanova
- Misty Elizabeth Chipalla
- Chiropractic Family Wellness, LLC
- Chiropractic First North PLLC
- Clearings Counseling Center Inc
- Brienna Lea Cobb
All providers in Roscoe, IL · Anesthesiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.