Provider Demographics
NPI:1407077258
Name:TINFANG, CHANTAL SYLVIE M (MD)
Entity Type:Individual
Prefix:
First Name:CHANTAL SYLVIE
Middle Name:M
Last Name:TINFANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHANTAL SYLVIE
Other - Middle Name:
Other - Last Name:GANGUEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-2400
Mailing Address - Country:US
Mailing Address - Phone:312-572-2900
Mailing Address - Fax:
Practice Address - Street 1:500 E 51ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2400
Practice Address - Country:US
Practice Address - Phone:312-572-2900
Practice Address - Fax:312-572-2462
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine