Individual provider Active NPI

Jordan Chen

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1154852796
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036.167774 Issued in IL
Practice address
3134 N Clark St
Chicago, IL 60657-4414
Phone
(773) 766-4949
Fax
(312) 766-4908
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036.167774 IL Primary

Addresses

Primary practice location

3134 N Clark St
Chicago, IL 60657-4414

Mailing address

29373 Network PL
Chicago, IL 60673-4414
Phone (847) 390-5900

Other practice location 1

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jchen393368@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230614004008 OH Practitioner - AnesthesiologyPractitioner - Pain Management 6709289697 Reassigns benefits to 1 organization
I20240226001860 IL Practitioner - Anesthesiology 6709289697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

3134 N Clark St
Chicago, IL 60657-4414
Phone (773) 296-5420

Hospital & facility affiliations

  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.167774ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Feb 4, 2024 Accepting new patients
Premier Pain Treatment Institute, LLC CurrentSince Jun 7, 2023 Accepting new patients
Premier Pain Treatment Institute CurrentSince Jun 7, 2023 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Feb 4, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

836 W Wellington Ave
Chicago, IL 60657
Phone (773) 296-7054

3134 N Clark St
Chicago, IL 60657
Phone (312) 766-4949

29373 Network Pl
Chicago, IL 60673

1301 Mattec Dr
Loveland, OH 45140
Phone (513) 454-7246

111 Vandament Way
Mount Orab, OH 45154
Phone (513) 454-7246

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1154852796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734414",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574414",
            "telephone_number": "773-766-4949",
            "fax_number": "312-766-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 W Wellington Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575147",
            "country_code": "US",
            "telephone_number": "773-975-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.167774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchen393368@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3134 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3134 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.