Healthcare Provider Details
I. General information
NPI: 1144201518
Provider Name (Legal Business Name): HORNER CHEN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
MORRIS HOSPITAL 150 WEST HIGH STREET
MORRIS IL
60450
US
IV. Provider business mailing address
11 N MEADOW CT
SOUTH BARRINGTON IL
60010-9529
US
V. Phone/Fax
- Phone: 815-942-2932
- Fax:
- Phone: 847-428-0148
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 36148 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: