Provider Demographics
NPI:1104822667
Name:CHAN, LINDA T (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:T
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:800 MACARTHUR BLVD
Mailing Address - Street 2:STE 21
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2918
Mailing Address - Country:US
Mailing Address - Phone:219-836-1163
Mailing Address - Fax:219-836-0588
Practice Address - Street 1:800 MACARTHUR BLVD
Practice Address - Street 2:STE 21
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2918
Practice Address - Country:US
Practice Address - Phone:219-836-1163
Practice Address - Fax:219-836-0588
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IN027982208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics