DAVID P CHAN (NPI# 1427057595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427057595 |
| Entity Type | Individual |
| Full Name | DAVID P CHAN |
| Credential | MD |
| Practice Address |
420 Ne Glen Oak Ave Peoria IL 61637-0001 |
| Practice Telephone | 3096553453 |
| Practice Fax Number | 3096553410 |
| Mailing Telephone | 3096553453 |
| Mailing Fax Number | 3096553410 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2012-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
35 063194 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0883147 | 05 | |
| IL | MEDICARE GROUP | 216946 | 01 |
| KY | 6493002700 | 05 | |
| WV | 0107855000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497289961 | David Chan | Podiatrist | 224d Cornwall St Nw # 203100, Leesburg, VA 20176-2713 | 2017-04-11 |
| 1649696717 | David W Chan | Dentist | 1095 Branham Ln., Suite #101, San Jose, CA 95136 | 2014-03-12 |
| 1982944005 | David Manfook Chan | Internal Medicine | 11815 Knightsbridge Pl, Loma Linda, CA 92354-4167 | 2013-02-26 |
| 1497068688 | David Deguire Chan | Internal Medicine | 10840 Warner Ave Ste 103, Fountain Valley, CA 92708-3847 | 2010-07-16 |
| 1538480181 | David Mein Wai Chan | Otolaryngology | 19550 Governors Hwy Ste 2350, Flossmoor, IL 60422-2125 | 2010-06-17 |
| 1720304405 | David Y Chan | Occupational Therapist | 81 Waterman, Irvine, CA 92602-1654 | 2010-04-20 |
| 1629279948 | David S Chan | Internal Medicine | 3616 S Normal Ave, Chicago, IL 60609-1722 | 2007-05-31 |
| 1417176009 | David K Chan | Dentist | 19120 Se 34th St, Suite104, Vancouver, WA 98683-1429 | 2007-04-24 |
| 1073651501 | David F Chan | Pharmacist | 1 Audubon Avenue, City Drug & Surgical, New York, NY 10032 | 2007-02-05 |
| 1477626968 | David Gavin Chan | Pharmacist | 11050 N 111th Way, Scottsdale, AZ 85259-6980 | 2006-11-15 |
| Street Address |
420 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164062196 | Tiara J Mullen | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3106 | 2020-01-07 |
| 1700308996 | Amanda Matthews | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603 | 2017-07-10 |
| 1871026450 | Shari S Mulvey | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2017-04-10 |
| 1003268897 | Sandra L. Peach | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2016-07-06 |
| 1083062285 | Heather A Boore | Clinical Nurse Specialist | 420 Ne Glen Oak Ave, Suite 401, Peoria, IL 61603 | 2016-05-27 |
| 1336546969 | Jennifer A. Nelson | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 201, Peoria, IL 61603-3105 | 2014-11-25 |
| 1003219932 | Linda Schmidgall | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 200, Peoria, IL 61603-3105 | 2014-10-07 |
| 1164839692 | Gregory Puszkiewicz | Pharmacist | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2014-07-16 |
| 1396183687 | Diana Warnecke | Nurse Practitioner | 420 Ne Glen Oak Ave, Ste 401, Peoria, IL 61603-3105 | 2013-06-07 |
| 1386081792 | Children's Hospital of Illinois Medical Group | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2013-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
| 1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| Find all providers in zip 61637 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740483627 | Priti M. Patel | Pediatrics | 530 Ne Glenoak Ave, Peoria, IL 61603-3133 | 2007-06-07 |
| 1386081792 | Children's Hospital of Illinois Medical Group | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2013-05-24 |
| 1851644256 | Jeffrey William Orcutt Jr. | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2012-10-23 |
| 1013146067 | Saint Francis Medical Center | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2009-07-13 |
| 1770744799 | Osf Multispecialty Group Peoria LLC | Pediatrics | 420 Ne Glen Oak Ave, Ste 304, Peoria, IL 61603-3105 | 2008-06-23 |
| 1164689428 | Matthew T Bramlet | Pediatrics | 420 Ne Glen Oak Ave, Suite 301, Peoria, IL 61603-3105 | 2008-05-22 |
| 1497879290 | Cecilia Anne Albaro | Pediatrics | 420 Ne Glen Oak Ave, Suite 301, Peoria, IL 61603-3105 | 2007-03-19 |
| 1982798146 | William H Albers | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| 1619061827 | Jitendra J Shah | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| 1417041666 | Stephen E Bash | Pediatrics | 420 Ne Glen Oak Ave, Suite 304, Peoria, IL 61603-3105 | 2006-10-03 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.