Chester Wilson Jr. (NPI# 1548245772, PAC ID# 8325020811) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1548245772 |
| PAC ID by PECOS | 8325020811 |
| Professional Enrollment ID | I20070924000648 |
| Full Name | Chester Wilson Jr. |
| Organization Legal Name | MICHIANA HEMATOLOGY-ONCOLOGY P C |
| Address |
1668 S Us Hwy 421 Westville IN 46391-9523 |
| Phone Number | 2197853400 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE |
| Graduation Year | 1989 |
| Primary Specialty | RADIATION ONCOLOGY |
| Group Practice PAC ID | 3375513419 |
| Number of Group Practice Members | 22 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150006 | LA PORTE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 | 5742371328 | MICHIANA HEMATOLOGY-ONCOLOGY P C |
| 1915 Lake Ave, Plymouth, IN 46563-9366 | 5749362585 | MICHIANA HEMATOLOGY-ONCOLOGY P C |
| 1668 S Us Hwy 421, Westville, IN 46391-9523 | 2197853400 | MICHIANA HEMATOLOGY-ONCOLOGY P C |
| Organization Legal Name | MICHIANA HEMATOLOGY-ONCOLOGY P C |
| Physicians | 25 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eduardo Braun | Medical Oncology | Michiana Hematology-oncology P C | 1668 S Us Hwy 421, Westville, IN 46391-9523 |
| Rafat H Ansari | Medical Oncology | Michiana Hematology-oncology P C | 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 |
| Mohamed Farhat | Medical Oncology | Michiana Hematology-oncology P C | 1205 S Main St, Suite 301, Crown Point, IN 46307-3677 |
| Binh N Tran | Radiation Oncology | Michiana Hematology-oncology P C | 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 |
| Brion B Shin | Radiation Oncology | Michiana Hematology-oncology P C | 1915 Lake Ave, Plymouth, IN 46563-9366 |
| Jody A Adams | Nurse Practitioner | Michiana Hematology-oncology P C | 1205 S Main St, Suite 301, Crown Point, IN 46307-3677 |
| Sheila M Fleming | Nurse Practitioner | Michiana Hematology-oncology P C | 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 |
| Bilal Ansari | Medical Oncology | Michiana Hematology-oncology P C | 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 |
| Jennifer C Ewing | Nurse Practitioner | Michiana Hematology-oncology P C | 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 |
| Rolan Allenegui Pascual | Medical Oncology | Michiana Hematology-oncology P C | 500 Arcade Ave, Suite 240, Elkhart, IN 46514-2485 |
| Street Address |
1668 S US HWY 421 |
| City | WESTVILLE |
| State | IN |
| Zip | 46391-9523 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eduardo Braun | Medical Oncology | Michiana Hematology-oncology P C | 1668 S Us Hwy 421, Westville, IN 46391-9523 |
| Robin T Zon | Medical Oncology | Michiana Hematology-oncology P C | 1668 S Us Hwy 421, Westville, IN 46391-9523 |
| Hyung Chil Kang | Medical Oncology | Michiana Hematology-oncology P C | 1668 S Us Hwy 421, Westville, IN 46391-9523 |
| David Allen Taber | Medical Oncology | Michiana Hematology-oncology P C | 1668 S Us Hwy 421, Westville, IN 46391-9523 |
| City | WESTVILLE |
| Zip Code | 46391 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | WESTVILLE + RADIATION ONCOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.