Dennis Chan, MD
in Maywood, IL. Individual provider (NPI-1).
NPI number1679005243
StatusActive
Last updated in NPPESOct 23, 2019
Details
- NPI
- 1679005243
- Entity type
- Individual (NPI-1)
- Name
- Dennis Chan
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 1, 2017
- Last updated
- Oct 23, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | 125.071442 | IL | Yes | |
| 207R00000X | Internal Medicine | 125.071442 | IL | |
| 2085R0001X | 4301115711 | MI | ||
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
2160 S 1st AveMaywood, IL 60153
Phone 888-584-7888
Mailing address
2160 S 1st AveMaywood, IL 60153-3328
Other practice locations
4201 Saint Antoine St
Detroit, MI 48201
Detroit, MI 48201
Phone 800-527-6266
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