Individual
MAO H. CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5600 W. ADDISON ST., SUITE 206, CHICAGO, IL 60634-4469
(773) 258-8090
(773) 481-6542
Mailing address
331 VINE ST, WILMETTE, IL 60091-3133
(773) 258-8090
(773) 481-6542
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036051346
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036051346
LICENSE #
IL
05
—
036051346
—
IL
01
—
110121944
RAILROAD MEDICARE PROVIDER #
IL
01
—
21607181
BCBS PROVIDER #
IL
Enumeration date
03/18/2006
Last updated
12/06/2012
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