Individual
KENNETH KIN KAN CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S. FIRST AVENUE, LOYOLA OUTPATIENT CENTER, 4300, MAYWOOD, IL 60153
(708) 216-6006
(708) 216-2683
Mailing address
2160 S. FIRST AVENUE, LOYOLA OUTPATIENT CENTER, 4300, MAYWOOD, IL 60153
(708) 216-6006
(708) 216-2683
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125065913
IL
Other
Enumeration date
04/07/2014
Last updated
09/26/2014
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