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General NPI Number Information
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NPI Number | 1528681210
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Entity Type | Organization
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Legal Business Name | NOLAN K M CHUN DDS PC
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 1560 SHERMAN AVE STE 520
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City | EVANSTON
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State | IL
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Zip | 60201-4806
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Country | US
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Telephone | 847-864-6951
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Fax | 847-864-6957
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Provider Business Mailing Address
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Address Line | 1560 SHERMAN AVE STE 520
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City | EVANSTON
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State | IL
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Zip | 60201-4806
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Country | US
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Telephone | 847-864-6951
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Fax | 847-864-6957
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | NOLAN CHUN
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Credential | DDS
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Telephone | 847-864-6951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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