Provider Demographics
NPI:1518040401
Name:CHEN, THOMAS TUNG (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:TUNG
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SPALDING DR STE 406
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6554
Mailing Address - Country:US
Mailing Address - Phone:630-961-9485
Mailing Address - Fax:630-961-9578
Practice Address - Street 1:100 SPALDING DR STE 406
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6554
Practice Address - Country:US
Practice Address - Phone:630-961-9485
Practice Address - Fax:630-627-0441
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060483207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060483Medicaid
IL1615022OtherBCBS ID #
IL417530Medicare PIN
IL1615022OtherBCBS ID #