Individual
JERRY CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1425 N RANDALL RD, ELGIN, IL 60123-2300
(847) 742-9800
Mailing address
2100 POWELL ST, SUITE 900, EMERYVILLE, CA 94608-1826
(510) 350-2600
(510) 879-9100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209008110
IL
Other
Enumeration date
03/26/2010
Last updated
04/08/2010
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