Fan, Jingyuan

Fan, Jingyuan is an individual health care provider with primary practice located at 3450 Lacey Road , Downers Grove IL 60515-2668. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Fan, Jingyuan can be contacted via phone (630) 743-4967.

Contact Information

Primary practice address
3450 Lacey Road Downers Grove IL 60515-2668
Phone: (630) 743-4967
Fax: (630) 743-4537
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 000054 New York

Profile Details

NPI number 1952718629
LBN Legal business name Fan, Jingyuan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2014
Last updated Aug 20th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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