Healthcare Provider Details

I. General information

NPI: 1376717751
Provider Name (Legal Business Name): ANTONIO RAMON CHAN LIGON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9050 N CHURCH DR
PARMA HEIGHTS OH
44130-4701
US

IV. Provider business mailing address

805 COLUMBIA RD STE 109
WESTLAKE OH
44145-1461
US

V. Phone/Fax

Practice location:
  • Phone: 440-292-0226
  • Fax: 440-292-0225
Mailing address:
  • Phone: 440-799-4224
  • Fax: 440-799-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35120822
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: