Chan, David P

Chan, David P is an individual health care provider with primary practice located at 420 Ne Glen Oak Ave , Peoria IL 61637-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Chan, David P can be contacted via phone (309) 655-3453.

Contact Information

Primary practice address
420 Ne Glen Oak Ave Peoria IL 61637-0001
Phone: (309) 655-3453
Fax: (309) 655-3410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 35 063194 Ohio
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 036122927 Illinois

Profile Details

NPI number 1427057595
LBN Legal business name Chan, David P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Mar 30th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427057595 NPPES
West Virginia MEDICAID 0107855000
West Virginia MEDICAID 0883147
West Virginia MEDICAID 6493002700
West Virginia Other 216946

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