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General NPI Number Information
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NPI Number | 1134253370
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Entity Type | Organization
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Legal Business Name | TERRACE OBSTETRICIANS & GYNECOLOGISTS SC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 1S132 SUMMIT AVE SUITE 305
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3955
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Country | US
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Telephone | 630-627-4954
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Fax | 630-627-0441
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Provider Business Mailing Address
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Address Line | 1S132 SUMMIT AVE SUITE 305
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3955
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Country | US
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Telephone | 630-627-4954
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Fax | 630-627-0441
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS T CHEN
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Credential | MD
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Telephone | 630-627-0147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036060483
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License Number State | IL
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