Individual provider Active NPI

Allen Edward Chantelois, MD

  • Diagnostic Radiology Physician
  • Neenah, WI
National Provider Identifier
1477539450
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35128 Issued in WI
Practice address
325 N Commercial St
Neenah, WI 54956-2665
Phone
(920) 722-1583
Fax
(920) 722-7454
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35128 WI Primary

Addresses

Primary practice location

325 N Commercial St
Neenah, WI 54956-2665

Mailing address

325 N Commercial St
Neenah, WI 54956-2665
Phone (920) 722-1583

Other identifiers 1

IdentifierTypeStateIssuer
32046700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35128WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology CurrentSince Nov 4, 2002 Accepting new patients
LK Anderson Consulting LLC PastSince Apr 26, 2024 Accepting new patients

Locations

333 N Commercial St
Ste 100
Neenah, WI 54956
Phone (920) 722-1750

325 N Commercial St
Neenah, WI 54956
Phone (920) 722-1583

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477539450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562665",
            "telephone_number": "920-722-1583",
            "fax_number": "920-722-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562665",
            "telephone_number": "920-722-1583",
            "fax_number": "920-722-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANTELOIS",
        "first_name": "ALLEN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "35128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32046700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.