Provider Demographics
NPI:1619265824
Name:CHENET, EDMOND JR
Entity Type:Individual
Prefix:MR
First Name:EDMOND
Middle Name:
Last Name:CHENET
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-5546
Mailing Address - Country:US
Mailing Address - Phone:847-888-1576
Mailing Address - Fax:847-888-1611
Practice Address - Street 1:16 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-5546
Practice Address - Country:US
Practice Address - Phone:847-888-1576
Practice Address - Fax:847-888-1611
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker