Provider Demographics
NPI:1932127701
Name:CHEN, BELINDA (MD)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 S WAUKEGAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-5204
Mailing Address - Country:US
Mailing Address - Phone:847-945-4575
Mailing Address - Fax:847-945-4593
Practice Address - Street 1:49 S WAUKEGAN RD STE 100
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5204
Practice Address - Country:US
Practice Address - Phone:847-945-4575
Practice Address - Fax:847-945-4593
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036102615208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102615Medicaid
IN200444640Medicaid
IL021622158OtherGROUP BLUE SHIELD #