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Organization
C T CHEN M D S C
Active
Organization
C T CHEN M D S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAO CHEN M.D. (PRESIDENT)
(847) 272-7460
Entity
Organization
Contact information
Practice address
6259 S COTTAGE GROVE AVE, CHICAGO, IL 60637-2529
(773) 752-2767
Mailing address
2220 ALLEN DR, NORTHBROOK, IL 60062-7603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036046856
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036049856
—
IL
05
—
3384809216006230
—
IL
Enumeration date
07/14/2006
Last updated
11/23/2012
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