Healthcare Provider Details

I. General information

NPI: 1487597647
Provider Name (Legal Business Name): MICHAEL E CHESTER JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 M 60 E
CASSOPOLIS MI
49031-9339
US

IV. Provider business mailing address

420 DECKER ST
NILES MI
49120-3450
US

V. Phone/Fax

Practice location:
  • Phone: 269-445-2451
  • Fax: 269-445-3216
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: