Healthcare Provider Details

I. General information

NPI: 1346877545
Provider Name (Legal Business Name): HUAFU CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

EAST TOWER 808 S. WOOD STREET 469A CME, M/C 724, EMERGENCY MEDICINE DEPT.
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-7297
  • Fax:
Mailing address:
  • Phone: 312-413-7492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125.075847
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: