Individual
JANA B CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
355 W 16TH STREET GOODMAN HALL, INDIANAPOLIS, IN 46202
(317) 963-7328
(317) 963-7313
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
20043084A
IN
103TC0700X
Clinical Psychologist
Primary
20043084A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001115087
ANTHEM PTAN
IN
05
—
300006445
—
IN
Enumeration date
09/04/2017
Last updated
03/05/2025
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