Individual
DR. CHAO CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021603999
BCBSIL PROVIDER NUMBER
IL
01
—
11163
AMERIGROUP PROVIDER NUMBE
IL
01
—
233891
HARMONY PROVIDER NUMBER
IL
Enumeration date
07/19/2006
Last updated
07/09/2007
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