Individual provider Active NPI

Joseph Chen, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1114152816
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007676 Issued in IL
Practice address
53 W Jackson Blvd Ste 824
Chicago, IL 60604-3487
Phone
(312) 835-7988
NPI assigned
May 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071007676 IL Primary

Addresses

Primary practice location

53 W Jackson Blvd Ste 824
Chicago, IL 60604-3487

Mailing address

PO Box 2193
Northbrook, IL 60065-2193
Phone (312) 835-7988

Other identifiers 1

IdentifierTypeStateIssuer
071-007676OtherIL071007676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071007676ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Transformedge, P.C. Clinical CurrentSince Feb 23, 2020 Accepting new patients
Davken Associates, P.C. Clinical PastSince May 1, 2016 Accepting new patients

Locations

53 W Jackson Blvd
Ste 824
Chicago, IL 60604
Phone (312) 835-7988

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1114152816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2193",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600652193",
            "telephone_number": "312-835-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD STE 824",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043487",
            "telephone_number": "312-835-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JOSEPH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-25",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "071007676",
            "identifier": "071-007676",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.