Basic Information
| Provider Information | |||||||||
| NPI: | 1730347022 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAPPO | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 SOUTHFIELD DR | ||||||||
| Address2: | SUITE 1370 | ||||||||
| City: | PLAINFIELD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461684498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178375570 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1000 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177454451 | ||||||||
| FaxNumber: | 3177186740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2008 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 02003401A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 02003401A | IN | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 205110VV | 01 | INDIVIDUAL MCR# HPN | OTHER | 000000635913 | 01 | ANTHEM PIN# HPN | OTHER | 200311740H | 01 | IN | MEDICAID GRP#/LOCATION HPN | OTHER | 200932120 | 05 | IN | MEDICAID |