WALLACE CHAN OD

Dr WALLACE CHAN OD is a male medical professional, specializing in Optometry. He graduated in 1990 from Illinois College Of Optometry At Chicago.

Contact

2126 A S ARCHER AVE
CHICAGO
IL
606161514

Tel:

WALLACE CHAN OD Information

Npi 1053360735
Pac Id 2062456460
Professional Enrollment Id I20050616000568
Last Name CHAN
First Name WALLACE
Middle Name
Suffix
Gender M
Credential OD
Medical School Name ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduation Year 1990
Primary Specialty OPTOMETRY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
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Organization Legal Name
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Number Of Group Practice Members
Line 1 Street Address 2126 A S ARCHER AVE
Line 2 Street Address
Marker Of Address Line 2 Suppression
City CHICAGO
State IL
Zip Code 606161514
Phone Number
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Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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