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General NPI Number Information
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NPI Number | 1962601112
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Entity Type | Individual
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Provider Name | IRENE CHEUNG-CHAN DPT/MBA
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Gender | Female
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 5550 S SHORE DR
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City | CHICAGO
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State | IL
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Zip | 60637-5051
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Country | US
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Telephone | 773-753-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 352 W 27TH ST
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City | CHICAGO
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State | IL
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Zip | 60616-2658
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IL
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