Active NPI
Ernest Chan, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Chicago, IL
National Provider Identifier
1558778282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 125064845
- Practice address
- 5841 S Maryland Ave
MC 3083
Chicago, IL 60637-1447 - Phone
- (773) 834-7708
- NPI assigned
- Jul 15, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 125064845 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave
MC 3083
Chicago, IL 60637-1447
Mailing address
5841 S Maryland Ave
MC 3803
Chicago, IL 60637-1447
Phone (773) 834-7708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122000642 | IL | Order and Referring Only - Pathology | 6103129341 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406419200000",
"number": "1558778282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"address_2": "MC 3803",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-834-7708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"address_2": "MC 3083",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-834-7708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ERNEST",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-15",
"last_updated": "2014-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "125064845",
"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 Jul 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.