Individual
MS. VIVIAN PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.G.C.
Contact information
Practice address
818 S WOLCOTT AVE, CHICAGO, IL 60612-3702
(312) 413-4478
(312) 996-5760
Mailing address
4525 N WESTERN AVE APT 4A, CHICAGO, IL 60625-6933
(312) 952-2584
(312) 996-5760
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
247000040
IL
170300000X
Genetic Counselor (M.S.)
74000062A
IN
Other
Enumeration date
07/01/2013
Last updated
03/27/2024
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