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General NPI Number Information
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NPI Number | 1972543239
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Entity Type | Individual
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Provider Name | JASON TSAI CHEN MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 8012 S CRANDON AVE STE 100
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City | CHICAGO
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State | IL
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Zip | 60617-1124
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Country | US
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Telephone | 773-356-5415
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Fax | 773-768-6141
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Provider Business Mailing Address
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Address Line | 1000 VILLAGE CENTER DR UNIT 204
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City | BURR RIDGE
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State | IL
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Zip | 60527-4540
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Country | US
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Telephone |
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Fax | 773-768-6141
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A76587
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036126956
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License Number State | IL
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