Individual
EDIE YEE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-4252
Mailing address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-4252
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
036109245
IL
208600000X
Surgery Physician
036109245
IL
208600000X
Surgery Physician
MD00045000
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
335890
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8430654
—
WA
Enumeration date
02/15/2007
Last updated
03/01/2022
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