Individual
DR. AILYN U TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5025 N PAULINA ST, CHICAGO, IL 60640-2772
(773) 989-1422
(773) 989-1447
Mailing address
PO BOX 1145, LIBERTYVILLE, IL 60048-4145
(888) 843-8475
(314) 849-6395
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632039
BLUESHIELD
IL
Enumeration date
07/31/2006
Last updated
11/06/2007
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