Organization
VAN MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NGAN T VAN M.D. (PRESIDENT)
(773) 267-2627
Entity
Organization
Contact information
Practice address
3637 W LAWRENCE AVE, CHICAGO, IL 60625-5625
(773) 267-2627
(773) 583-8559
Mailing address
3637 W LAWRENCE AVE, CHICAGO, IL 60625-5625
(773) 267-2627
(773) 583-8559
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1626090
BCBS OF IL
IL
Enumeration date
05/01/2007
Last updated
11/27/2007
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