Provider Demographics
NPI:1811900186
Name:CHEN, YUAN (MD)
Entity type:Individual
Prefix:DR
First Name:YUAN
Middle Name:
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 1:1205 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-2006
Mailing Address - Country:US
Mailing Address - Phone:630-809-9707
Mailing Address - Fax:630-388-0706
Practice Address - Street 1:1205 OAK ST
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-2006
Practice Address - Country:US
Practice Address - Phone:630-809-9707
Practice Address - Fax:630-388-0706
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036106664207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106664Medicaid
ILI01169Medicare UPIN
IL206611Medicare ID - Type Unspecified