Hi Aaron,
I'm 6 ft tall, 185 lbs, 42 in. chest and for wearing over a base layer and midlayer, I'd fit a Large Thermawrap Parka (hooded) – it would fit me snuggly but not at all tight – just right. If you wear it the same way you'd be a Medium. That said, I prefer to wear it belay-style over all layers, so I can use over all layers at rest stops in addition to in camp and as part of a sleep system, so I wear an XL only for that reason. I tried on a M, L and XL when I bought.
If you are looking for the Medium, I have one for sale in excellent like-new condition that will save you a good $60-90 over the new one depending on what the price is now. Bought it for my wife, but with us already using a few pieces of outerwear we've bought that are the same color, I picked up a women's Thermawrap for her in a different color. Now we no longer look like members of an adventure racing team (not that that's a bad thing to be identified with).
Posted here a month or two ago but no one in a size Medium was looking at the time. Was going to repost before finally selling on Feebay. PM me if you're interested.