Provider Demographics
NPI:1811599749
Name:CHEN, MEI CHUN
Entity Type:Individual
Prefix:
First Name:MEI CHUN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 ROOSEVELT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-2057
Mailing Address - Country:US
Mailing Address - Phone:708-344-1422
Mailing Address - Fax:
Practice Address - Street 1:4413 ROOSEVELT RD STE 101
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2057
Practice Address - Country:US
Practice Address - Phone:708-344-1422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist