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General NPI Number Information
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NPI Number | 1144204397
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Entity Type | Individual
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Provider Name | ROBISON CHAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 05/03/2018
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Provider Practice Location Address
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Address Line | 1855 WEST TAYLOR STREET
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City | CHICAGO
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State | IL
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Zip | 60612-7242
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Country | US
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Telephone | 312-996-6590
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Fax | 312-996-7770
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Provider Business Mailing Address
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Address Line | 1855 WEST TAYLOR STREET
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City | CHICAGO
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State | IL
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Zip | 60612-7242
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Country | US
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Telephone | 312-996-6590
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Fax | 312-996-7770
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036.138574
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License Number State | IL
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