Individual
DR. AINAH UY TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
430 PENNSYLVANIA AVE # 180, GLEN ELLYN, IL 60137-4464
(630) 469-9200
(630) 545-7817
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
125.064328
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036142909
—
IL
Enumeration date
04/25/2013
Last updated
08/23/2023
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