Provider Demographics
NPI:1427418607
Name:NAY, CHESTER (PA-C)
Entity Type:Individual
Prefix:
First Name:CHESTER
Middle Name:
Last Name:NAY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-3228
Mailing Address - Country:US
Mailing Address - Phone:618-283-3144
Mailing Address - Fax:618-283-3194
Practice Address - Street 1:1510 SUNSET DR
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-3228
Practice Address - Country:US
Practice Address - Phone:618-283-3144
Practice Address - Fax:618-283-3194
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005770363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant