KENNETH KIN KAN CHAN M.D. NPI 1124446117

NPI Information

  • NPI: 1124446117
  • Provider Name: KENNETH KIN KAN CHAN, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 2160 S. FIRST AVENUE
    LOYOLA OUTPATIENT CENTER, 4300
    MAYWOOD, IL
    ZIP 60153
  • Phone: (708) 216-6006

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NPI Details

Kenneth Kin Kan Chan, M.D. is a family medicine in Maywood, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Kenneth Kin Kan Chan, M.D. NPI is 1124446117. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2160 S. FIRST AVENUE
LOYOLA OUTPATIENT CENTER, 4300
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-6006
Fax: (708) 216-2683

The enumeration date for this NPI number is 4/7/2014 and was last updated on 9/26/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine125065913ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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