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General NPI Number Information
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NPI Number | 1194611046
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Entity Type | Individual
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Provider Name | TIMMY Z CHEN DMD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 237 S MAIN ST
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City | LOMBARD
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State | IL
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Zip | 60148-2647
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Country | US
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Telephone | 630-620-8304
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Fax |
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Provider Business Mailing Address
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Address Line | 215 W LAKE ST
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City | CHICAGO
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State | IL
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Zip | 60606-1859
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Country | US
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Telephone | 813-842-0138
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.036129
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License Number State | IL
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