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NPI Code Detail

MEDICARE: BAI FAN CHEN MD

MEDICARE: BAI FAN CHEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician036047813IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821087727
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAI FAN CHEN MD
Provider Business Mailing Address
First Line : 2320 HIGH ST
Second Line :
City : BLUE ISLAND
State : IL
Zip : 60406-2426
Country : US
Telephone Number : 708-388-5500
Fax Number : 708-388-5672
Provider Business Practice Location Address
First Line : 2320 HIGH ST
Second Line :
City : BLUE ISLAND
State : IL
Zip : 60406-2426
Country : US
Telephone Number : 708-388-5500
Fax Number : 708-388-5672
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 05/20/2008

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Practice Location Address:
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Directions to “ BAI FAN CHEN MD” Practice Location

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