Kenneth Kin Kan Chan, M.D.
Family Medicine in Maywood, IL. Individual provider (NPI-1).
NPI number1124446117
StatusActive
Last updated in NPPESSep 26, 2014
Details
- NPI
- 1124446117
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Kin Kan Chan
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 7, 2014
- Last updated
- Sep 26, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 125065913 | IL | Yes |
Practice location
2160 S. First AvenueLoyola Outpatient Center, 4300
Maywood, IL 60153
Phone 708-216-6006 · Fax 708-216-2683
Mailing address
2160 S. First AvenueLoyola Outpatient Center, 4300
Maywood, IL 60153
Phone 708-216-6006 · Fax 708-216-2683
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