Search › Illinois › 363A00000X
Edward Supan, PA-C
NPI 1477013407 · on the registry since 2019
Practice
- Address
- 635 N Dearborn St
Chicago, IL 60654 - Phone
- (312) 694-2273
- Fax
- (312) 694-2129
- Clinicians at this address
- 58
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-05-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois