Individual
MR. KEVIN C CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3405 OFFICE PARK DR, MARION, IL 62959-6478
(618) 997-8412
(618) 997-3726
Mailing address
PO BOX 1887, MARION, IL 62959
(618) 997-8412
(618) 997-3726
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036108368
IL
207R00000X
Internal Medicine Physician
36108368
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635188
BCBS
IL
01
—
036108368
ILLINOIS LICENSE
IL
05
—
036108368
—
IL
01
—
104897
HEALTH ALLIANCE
IL
Enumeration date
08/11/2006
Last updated
08/13/2024
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