Provider Demographics
NPI:1053369124
Name:CHEN, MERI ELENA (MD)
Entity type:Individual
Prefix:DR
First Name:MERI
Middle Name:ELENA
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:SUITE 456
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-563-4270
Mailing Address - Fax:312-563-4280
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 456
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-563-4270
Practice Address - Fax:312-563-4280
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360848842085R0202X
IL36084884174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG08081Medicare UPIN