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General NPI Number Information
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NPI Number | 1871943092
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Entity Type | Individual
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Provider Name | STEVEN C QUAN
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Gender | Male
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Dates
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Enumeration Date | 06/18/2016
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60637-1443
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Country | US
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Telephone | 888-824-0200
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Fax | 773-702-0830
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Provider Business Mailing Address
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Address Line | 150 HARVESTER DR SUITE 300
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City | BURR RIDGE
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State | IL
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Zip | 60527-5919
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Country | US
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Telephone |
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046011138
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License Number State | IL
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