Provider Demographics
NPI:1528681210
Name:NOLAN K M CHUN DDS PC
Entity type:Organization
Organization Name:NOLAN K M CHUN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-864-6951
Mailing Address - Street 1:1560 SHERMAN AVE STE 520
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4806
Mailing Address - Country:US
Mailing Address - Phone:847-864-6951
Mailing Address - Fax:847-864-6957
Practice Address - Street 1:1560 SHERMAN AVE STE 520
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4806
Practice Address - Country:US
Practice Address - Phone:847-864-6951
Practice Address - Fax:847-864-6957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental