David P Chan

MD | Pediatric Cardiology | Male

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Complete Profile:

David P Chan basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Cardiology
Provider Name :	David P Chan
Credential :	MD
Gender :	Male

Business Address:

David P Chan address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	420 Ne Glen Oak Ave Peoria, IL, 61637-0001 United States
Phone Number :	309-655-3453
Fax Number :	309-655-3410

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1427057595
NPI Entity Type :	Individual
First Enrolment Date :	20 Jul, 2005
Last Updated On :	30 Mar, 2022

Medicare Participation:

David P Chan participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	1153471701
Medicare Enrollment ID :	I20090603000079
Primary Specialty :	Cardiovascular Disease (cardiology)
Medical School :	Wayne State University School Of Medicine
Graduation Year :	1986
Accepts Medicare?	Yes. David P Chan accepts medicare insurance.

Group Practice Association:

David P Chan is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which David P Chan is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Carle Health Care Incorporated	3577515774	803	611 W Park St Urbana, IL - 618012500 Ph: 8887122753	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for David P Chan are as mentioned. Primary taxonomy code for David P Chan, MD is 2080P0202X (Pediatrics Pediatric Cardiology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0202X	Pediatrics Pediatric Cardiology	No	35 063194	OH
2080P0202X	Pediatrics Pediatric Cardiology	Yes	036122927	IL

Legacy Identifiers:

Other legacy medical identifiers of David P Chan such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
0107855000	MEDICAID	WV
6493002700	MEDICAID	KY
216946	Other	IL	MEDICARE GROUP
0883147	MEDICAID	OH

Other Practice Locations:

Practice Address	City, State	Phone Number
611 W PARK ST, URBANA, IL, 61801-2529 United States	URBANA, IL	217-383-3100
1302 FRANKLIN AVE STE 3400, NORMAL, IL, 61761-6523 United States	NORMAL, IL	309-556-8300

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	611 W. Park St., Fapc Urbana, IL, 61801 United States

Business Location:

Patients can refer following map for directions to David P Chan practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.