Healthcare Provider Details

I. General information

NPI: 1619118536
Provider Name (Legal Business Name): MAC MEDICAL SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2314 S ROUTE 59 #180
PLAINFIELD IL
60586-7756
US

IV. Provider business mailing address

2314 S ROUTE 59 #180
PLAINFIELD IL
60586-7756
US

V. Phone/Fax

Practice location:
  • Phone: 815-685-2308
  • Fax: 815-439-7082
Mailing address:
  • Phone: 815-685-2308
  • Fax: 815-439-7082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number036117307
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036074277
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ALAN HSAIO-FENG CHEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 909-418-7772