Provider Demographics
NPI:1396132403
Name:CHAN, NICHOLAS KARJUN (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:KARJUN
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6201 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3888
Mailing Address - Country:US
Mailing Address - Phone:086-369-3937
Mailing Address - Fax:708-636-2022
Practice Address - Street 1:6201 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3888
Practice Address - Country:US
Practice Address - Phone:708-636-9393
Practice Address - Fax:708-636-2022
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036152835207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology