TIM PAN
NPI 1023817228
Student in an Organized Health Care Education/Training Program in Chicago, IL

Q: What is Tim Pan's NPI number?

The NPI number for Tim Pan is 1023817228. It was assigned to this individual provider in the NPPES registry on March 10, 2025.

Q: What is Tim Pan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Tim Pan was last updated on March 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 10, 2025PECOS Enrolled

1853 W POLK ST, CHICAGO, IL 60612(312) 996-2450 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 23, 2026, Mar 10, 2025 (2 updates tracked since 2025).

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About Tim Pan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIM PAN (NPI 1023817228) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023817228

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameTIM PAN

Location Address1853 W POLK STChicago, IL 60612-4355

Mailing Address1853 W Polk StChicago, IL 60612-4355

Phone(312) 996-2450

Sole ProprietorNo

Enumeration DateMarch 10, 2025

Last NPPES UpdateMarch 23, 20262 updates tracked since enumeration

NPPES CertifiedMarch 23, 2026

✔ NPI 1023817228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1853 W POLK ST, Chicago, IL 60612

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tim Pan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JUNYUN PARK

Student in an Organized Health Care Education/Training Program