David Jonathan Tan, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085004064 Issued in IL

Practice address

2940 Rollingridge Rd
Suite 102
Naperville, IL 60564-4231

Phone

(630) 579-6500

Fax

(630) 579-5860

NPI assigned

Oct 25, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1467752402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213186",
            "telephone_number": "630-579-6500",
            "fax_number": "630-579-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 ROLLINGRIDGE RD",
            "address_2": "SUITE 102",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644231",
            "telephone_number": "630-579-6500",
            "fax_number": "630-579-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "DAVID",
        "middle_name": "JONATHAN",
        "name_prefix": "Prof.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-25",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085004064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Debby T Tang, PH.D.
• Julian H Tang, M.D.

• Surgical Physician Assistant in Naperville, IL
• Providers in Naperville, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.