Organization Active NPI

Ailyn Tan MD SC

  • Clinical Medical Laboratory
  • Chicago, IL
National Provider Identifier
1497942783
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
AILYN TAN MD SC
Practice address
5025 N Paulina St
Chicago, IL 60640-2772
Phone
(773) 989-1422
NPI assigned
Oct 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Ailyn U Tan, MD
Title
Owner
Phone
(773) 989-1422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X IL Primary

Addresses

Primary practice location

5025 N Paulina St
Chicago, IL 60640-2772

Mailing address

PO Box 1145
Libertyville, IL 60048-4145
Phone (773) 989-1422

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1497942783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1145",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484145",
            "telephone_number": "773-989-1422",
            "fax_number": "773-989-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 N PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402772",
            "telephone_number": "773-989-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AILYN TAN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "AILYN",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-989-1422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": null,
            "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 Oct 1, 2007; 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.