| Chestnut Health Of Missouri Llc | |
|
13700 Old Halls Ferry Rd Black Jack MO 63033-4109 | |
| (314) 355-0760 | |
| (703) 649-6188 |
| Full Name | Chestnut Health Of Missouri Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13700 Old Halls Ferry Rd, Black Jack, Missouri |
| Authorized Official Name and Position | Jai Kumar (ADMINISTRATOR) |
| Authorized Official Contact | 7033486060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chestnut Health Of Missouri Llc 1530 N Randall Rd Ste 210 Elgin IL 60123-7879 Ph: (703) 348-6060 | Chestnut Health Of Missouri Llc 13700 Old Halls Ferry Rd Black Jack MO 63033-4109 Ph: (314) 355-0760 |
| NPI Number | 1659195345 |
|---|---|
| Provider Enumeration Date | 11/11/2024 |
| Last Update Date | 11/11/2024 |
| Medicare PECOS PAC ID | 4183144124 |
|---|---|
| Medicare Enrollment ID | O20250221000236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659195345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kuljit Kapur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831399518 PECOS PAC ID: 2860649985 Enrollment ID: I20250221000327 |
Ameriwound Physicians Mo Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13700 Old Halls Ferry Rd, Black Jack, MO 63033 Phone: 314-355-0760 | |
Long Term Care Of North County Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4401 Parker Rd, Black Jack, MO 63033 Phone: 314-312-0720 |