KENNETH KIN KAN CHAN (NPI# 1124446117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124446117 |
| Entity Type | Individual |
| Full Name | KENNETH KIN KAN CHAN |
| Credential | M.D. |
| Practice Address |
2160 S. First Avenue Loyola Outpatient Center, 4300 Maywood IL 60153 |
| Practice Telephone | 7082166006 |
| Practice Fax Number | 7082162683 |
| Mailing Telephone | 7082166006 |
| Mailing Fax Number | 7082162683 |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 125065913 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811079106 | Kenneth Ka Chan | Dentist | 1315 Fair Oaks Ave Ste 103, South Pasadena, CA 91030-3868 | 2006-10-19 |
| 1912091919 | Kenneth Dong Chan | Internal Medicine | 789 Vallejo St, San Francisco, CA 94133-3834 | 2006-10-03 |
| 1033421177 | Kenneth Chan | Occupational Therapist | 18 Heyward St, Brooklyn, NY 11211-9210 | 2010-07-06 |
| 1336306083 | Kenneth Kian-lip Chan | Physician Assistant | 11 Bishop Place, Occupational Health Dept B3, New Brunswick, NJ 08901 | 2008-05-20 |
| 1780762435 | Kenneth K.m. Chan | Internal Medicine | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2006-11-01 |
| 1861422370 | Kenneth Mankin Chan | Internal Medicine | 207 S Santa Anita Ave, San Gabriel, CA 91776-1146 | 2006-07-03 |
| 1649236480 | Kenneth Kai Hei Chan | Specialist | 23441 Madison St, #290, Torrance, CA 90505-4725 | 2006-04-21 |
| 1720042138 | Kenneth Chan | Psychiatry & Neurology | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2006-04-13 |
| 1639178460 | Kenneth Kwok-chun Chan | Pediatrics | 140 Haverhill St, Andover, MA 01810-1504 | 2005-07-14 |
| Street Address |
2160 S. FIRST AVENUE LOYOLA OUTPATIENT CENTER, 4300 |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154397495 | Geoffrey Silver | Surgery | 2160 S. First Avenue, Bldg 110, 3rd Floor, Maywood, IL 60153 | 2006-02-27 |
| 1912496704 | Daniel Luc Guay | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Maywood, IL 60153 | 2018-05-07 |
| 1235661331 | Patricia Lee | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2017-03-29 |
| 1407387152 | Swapna Gudipati | Internal Medicine | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153-3328 | 2017-03-24 |
| 1295266187 | Peter Jeffrey Laub | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Maywood, IL 60153-3328 | 2017-03-23 |
| 1508307778 | Matthew James Mcshane | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153-3335 | 2017-03-20 |
| 1265827422 | Ioannis Angelidis | Surgery | 2160 S. First Avenue, Loyola Medical Center, Ems Bldg 110- Room 3210, Maywood, IL 60153 | 2015-04-03 |
| 1225423114 | Emanuel Eguia | Surgery | 2160 S. First Avenue, Loyola University Medical Cente Ems Bldg 110- Room 3210, Maywood, IL 60153 | 2015-03-30 |
| 1952729527 | Thomas Waddell Smith Jr. | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Maywood, IL 60153 | 2014-04-01 |
| 1952728081 | Angeline Fu-hsiuan Pai | Family Medicine | 2160 S. First Avenue, 4300 Loyola Outpatient Center, Maywood, IL 60153 | 2014-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760613756 | Alma Comprehensive Medical Center, Ltd | Family Medicine | 1411 S 5th Ave, Maywood, IL 60153-2128 | 2009-08-07 |
| 1902080708 | Clinica Medica De La Caridad Medical Group Inc | Family Medicine | 4347 E. Slauson Ave, Maywood, CA 90270-2837 | 2007-12-28 |
| 1073580262 | George Leipsner | Family Medicine | 57 W Pleasant Ave, Maywood, NJ 07607-1334 | 2006-03-07 |
| 1225021462 | Maged Z Basilios | Family Medicine | 4505 Slauson Ave, Suite E, Maywood, CA 90270-4942 | 2005-08-23 |
| 1922560812 | Reshma Hitesh Patel | Family Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-04-01 |
| 1184071896 | Sudheer Earanky | Family Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-05-23 |
| 1710333000 | Noel-marie Chelsea Fischre | Family Medicine | 2160 S 1st Ave, Fahey Building, Room 251, Maywood, IL 60153-3328 | 2016-05-05 |
| 1053765685 | Victoria Coraglio | Family Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-04-20 |
| 1093177230 | Michael Gregory Mank | Family Medicine | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-03-27 |
| 1922494061 | Mary Eguia | Family Medicine | 1211 W Roosevelt Rd, Maywood, IL 60153 | 2015-04-14 |
| Find all providers in MAYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.