Lucas Chan, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Maywood, Illinois. His current practice location is
2160 S 1st Ave, Maywood, Illinois. You can reach out to his office (for appointments etc.) via phone at
(708) 216-4943.
Lucas Chan is licensed to practice in Illinois (license number 036.152830) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578094710.
Physician's Profile
| Full Name | Lucas Chan |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 2160 S 1st Ave, Maywood, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578094710
- Provider Enumeration Date: 03/21/2017
- Last Update Date: 07/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 5294006706
- Enrollment ID: I20200818002264
Medical Identifiers
Medical identifiers for Lucas Chan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1578094710 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 036152830 (Illinois) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 036.152830 (Illinois) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 036.152830 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lucas Chan allows following entities to bill medicare on his behalf.
| Entity Name | Gottlieb Community Health Services Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013415603
PECOS PAC ID: 3375442999
Enrollment ID: O20180420000980 |
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| Entity Name | Loyola Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376041954
PECOS PAC ID: 6305109547
Enrollment ID: O20180420002063 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lucas Chan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Lucas Chan, MD
2160 S 1st Ave,
Maywood, IL 60153-3328
Ph: (708) 216-4943 | Lucas Chan, MD
2160 S 1st Ave,
Maywood, IL 60153-3328
Ph: (708) 216-4943 |
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