Cheng Li Chin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19015811 Issued in IL

Practice address

2021 N Western Ave
Chicago, IL 60647-4103

Phone

(773) 772-4114

Fax

(773) 772-4114

NPI assigned

Oct 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cheng Li Chin D.D.S.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1154595106
  NPD (past) Authorized official

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

{
    "created_epoch": "1129939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1376533299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474103",
            "telephone_number": "773-772-4114",
            "fax_number": "773-772-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474103",
            "telephone_number": "773-772-4114",
            "fax_number": "773-772-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "CHENG",
        "middle_name": "LI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-22",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19015811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3629607116009101",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19015811",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chinecherem Chime-Eze, MD
• Chimera Health PLLC
• Christine Lynn Chimera, MA
• Michael Chin-Robinson
• Anthony C Chin, MD
• Christine Soojung Chin, DO
• Christopher Chin
• Deanna Chin
• Harold W Chin, MD
• Hok Leong Chin

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.