Vivian Pan, C.G.C.

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

247000040 Issued in IL

Practice address

818 S Wolcott Ave
Chicago, IL 60612-3702

Phone

(312) 413-4478

Fax

(312) 996-5760

NPI assigned

Jul 1, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1750721049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 N WESTERN AVE APT 4A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606256933",
            "telephone_number": "312-952-2584",
            "fax_number": "312-996-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 S WOLCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123702",
            "telephone_number": "312-413-4478",
            "fax_number": "312-996-5760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 S Wood St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081202",
            "country_code": "US",
            "telephone_number": "312-355-3248",
            "fax_number": "312-996-5760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAN",
        "first_name": "VIVIAN",
        "name_prefix": "Ms.",
        "credential": "C.G.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "IN",
            "license": "74000062A",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "IL",
            "license": "247000040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chun-Wei Pan, MD
• Eric Pan
• Joshua Pan
• Stacey Jane Pan, PHARMD
• Tim Pan
• Yu Pan
• Demitra Panagakis, MSW
• Patoula Panagos-Billiris, MD
• Juliet Ibanez Panambo Kantoff, AGPCNP
• Mark J Panarese, APN-CRNA

• Genetic Counselor (M.S.) in Chicago, IL
• Providers in Chicago, IL by specialty
• Genetic Counselor (M.S.) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.