# C T CHEN M D S C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932125051
- **Authorized official:** DR. CHAO CHEN M.D. (PRESIDENT)
- **Authorized official phone:** (847) 272-7460

## Contact information

- **Practice address:** 6259 S COTTAGE GROVE AVE, CHICAGO, IL 60637-2529
- **Practice address phone:** (773) 752-2767
- **Mailing address:** 2220 ALLEN DR, NORTHBROOK, IL 60062-7603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 036046856 | IL | Yes |

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 11/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036049856 | — | IL |
| 05 | — | 3384809216006230 | — | IL |