Provider Demographics
NPI:1861459034
Name:CHAMNESS, KAREN (PA-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CHAMNESS
Suffix:
Gender:F
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:STEELEVILLE CLINIC
Mailing Address - Street 2:9 WESTWOOD DR
Mailing Address - City:STEELEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62288
Mailing Address - Country:US
Mailing Address - Phone:618-965-3466
Mailing Address - Fax:
Practice Address - Street 1:STEELEVILLE CLINIC
Practice Address - Street 2:9 WESTWOOD DR
Practice Address - City:STEELEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62288
Practice Address - Country:US
Practice Address - Phone:618-965-3466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036080189363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILS37516Medicare UPIN