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Individual

CHEN YANG KUAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2160 S 1ST AVE, LOYOLA OUTPATIENT CENTER, 4300, MAYWOOD, IL 60153-3328
(708) 216-6006
(708) 216-2683
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125066058
IL

Other

Enumeration date
03/26/2014
Last updated
09/25/2014
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