Provider Demographics
NPI:1790384386
Name:BIAN CHICAGO MEDICAL MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:BIAN CHICAGO MEDICAL MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHE YEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-743-4885
Mailing Address - Street 1:600 W CHICAGO AVE STE 001
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-2802
Mailing Address - Country:US
Mailing Address - Phone:206-743-4885
Mailing Address - Fax:
Practice Address - Street 1:600 W CHICAGO AVE
Practice Address - Street 2:SUITE 001
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-2802
Practice Address - Country:US
Practice Address - Phone:206-743-4885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty