MEDICARE: YUI Y CHAN, M.D.S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	36045083	IL

General Provider Information

NPI Number	:	1023380300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YUI Y CHAN, M.D.S.C.

Provider Business Mailing Address
First Line	:	2171 S CHINA PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1536
Country	:	US
Telephone Number	:	312-842-9888
Fax Number	:	312-842-9882

Provider Business Practice Location Address
First Line	:	2171 S CHINA PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1536
Country	:	US
Telephone Number	:	312-842-9888
Fax Number	:	312-842-9882

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. YUI Y CHAN
Credential	:	MD
Telephone Number	:	312-842-9888

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	02/02/2012

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