Individual
DR. CHENG LI CHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2021 N WESTERN AVE, CHICAGO, IL 60647-4103
(773) 772-4114
(773) 772-4114
Mailing address
2021 N WESTERN AVE, CHICAGO, IL 60647-4103
(773) 772-4114
(773) 772-4114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19015811
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19015811
—
IL
05
—
3629607116009101
—
IL
Enumeration date
10/22/2005
Last updated
04/16/2008
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