Individual ProviderPei Hsuan ChanFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1 Erie Ct Ste 6160, Oak Park, IL 60302-2510(708) 383-0113(626) 872-7140PECOS EnrollmentBased on the most recent information from CMS, provider Pei Hsuan Chan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1508423054Provider TypeIndividualFull NameChan, Pei HsuanCredentialDOSole ProprietorNoEnumeration Date5/21/2019Last Updated9/15/2024Contact InformationPractice LocationPractice Address1 Erie Ct Ste 6160, Oak Park, IL 60302-2510Phone(708) 383-0113FaxUnlisted FaxMailing LocationMailing Address1140 Dunlop Ave Unit Gn, Forest Park, IL 60130-2281Phone(626) 872-7140FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense125.081994IllinoisCode208D00000XDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicense5101025890Michigan