Healthcare Provider Details

I. General information

NPI: 1568922425
Provider Name (Legal Business Name): VICTOR SHI CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2355
US

IV. Provider business mailing address

880 W CENTRAL RD STE 5000
ARLINGTON HEIGHTS IL
60005-2384
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-3800
  • Fax:
Mailing address:
  • Phone: 847-618-3800
  • Fax: 847-618-3809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number125.073714
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number036169303
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: