Provider Demographics
NPI:1013967876
Name:CHAN, ASHLEY YUEN-LING (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:YUEN-LING
Last Name:CHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 DAVIS ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4668
Mailing Address - Country:US
Mailing Address - Phone:847-328-8990
Mailing Address - Fax:847-328-9075
Practice Address - Street 1:500 DAVIS ST
Practice Address - Street 2:SUITE 106
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4668
Practice Address - Country:US
Practice Address - Phone:847-328-8990
Practice Address - Fax:847-328-9075
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-026776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist