Kimberly Karshue Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.028001 Issued in IL

Practice address

5131 N Lincoln Ave
Chicago, IL 60625-2585

Phone

(773) 271-5596

NPI assigned

Oct 4, 2010

Last updated

Oct 4, 2010By the provider in NPPES

Sex

Female

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

State licenses

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1619286911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 W CHURCHILL ST",
            "address_2": "APT 407",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606476027",
            "telephone_number": "312-927-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252585",
            "telephone_number": "773-271-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KIMBERLY",
        "middle_name": "KARSHUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.028001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica H Chan, D.C.
• Jimmy Chan, LCSW, LPHA
• Jit Chan, DDS
• John Chan, RPH
• Juliana Chan, PHARM.D.
• Kristine N Chan, DPT
• Kyle Samuel Chan, MD
• Megan Chan, MD
• Michelle Chan, DO
• Michelle Chan, OD

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.