Individual
DR. KYLE SAMUEL CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
240 E HURON ST STE 1-200, CHICAGO, IL 60611-2909
(312) 503-7975
Mailing address
240 E HURON ST STE 1-200, CHICAGO, IL 60611-2909
(312) 503-7975
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
125084100
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/27/2019
Last updated
06/14/2024
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