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General NPI Number Information
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NPI Number | 1700462074
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Entity Type | Individual
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Provider Name | KEVIN CHEN NP-C
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Gender | Male
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 1355 S HALSTED ST UNIT 304
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City | CHICAGO
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State | IL
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Zip | 60607-5010
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Country | US
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Telephone | 630-445-3891
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Fax |
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Provider Business Mailing Address
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Address Line | 621 SARA LN
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City | NAPERVILLE
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State | IL
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Zip | 60565-1611
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Country | US
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Telephone | 630-445-3891
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 209022454
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License Number State | IL
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