Individual
CARMEN CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2803 W 95TH ST, EVERGREEN PARK, IL 60805-2702
(312) 619-2736
Mailing address
2922 S LOWE AVE, CHICAGO, IL 60616-3033
(312) 619-2736
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019037384
IL
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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