Active NPI
David Chung Man Chan, PHARMD, PHD
- Pharmacist
- Chicago, IL
National Provider Identifier
1013594753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051299074
- Practice address
- 1740 W Taylor St
Chicago, IL 60612-7232 - Phone
- (312) 996-4541
- NPI assigned
- Mar 27, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3553 | NH | |
| Pharmacist | 183500000X | 051299074 | IL | Primary |
Addresses
Primary practice location
1740 W Taylor St
Chicago, IL 60612-7232
Mailing address
3215 Central Ave
Wilmette, IL 60091-2006
Phone (603) 252-5807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051299074 | IL | MD | Pharmacist |
| 3553 | NH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616803200000",
"number": "1013594753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3215 CENTRAL AVE",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600912006",
"telephone_number": "603-252-5807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127232",
"telephone_number": "312-996-4541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "DAVID",
"middle_name": "CHUNG MAN",
"credential": "PHARMD, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-27",
"last_updated": "2021-03-27",
"certification_date": "2021-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "3553",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051299074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.