Provider Demographics
NPI:1336670017
Name:HU, KEVIN SHAWN CHEN (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:SHAWN CHEN
Last Name:HU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:HU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2653 W OGDEN AVE STE 3B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1647
Mailing Address - Country:US
Mailing Address - Phone:773-522-6100
Mailing Address - Fax:
Practice Address - Street 1:2653 W OGDEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1647
Practice Address - Country:US
Practice Address - Phone:773-522-6100
Practice Address - Fax:773-522-9831
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036152679207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine