Active NPI
Alice Chen, M.D.
- Legal Medicine
- Skokie, IL
National Provider Identifier
1497752893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- 0036-086420
- Practice address
- 4711 Golf Rd
Suite 808
Skokie, IL 60076-1224 - Phone
- (847) 568-1870
- Fax
- (847) 568-1875
- NPI assigned
- Jun 30, 2005
- Reactivated
- Mar 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 0036-086420 | IL | Primary |
Addresses
Primary practice location
4711 Golf Rd
Suite 808
Skokie, IL 60076-1224
Mailing address
PO Box 1406
Park Ridge, IL 60068-7406
Phone (847) 568-1870
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14D0937849 | Other | IL | CLIA ID |
| 036086420 | Medicaid | IL | |
| 1621458 | Other | IL | BLUE CROSS/BLUE SHEILD |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0036-086420 | IL | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Gynecology, S.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Mt Prospect, IL
- NPI 1679844039
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570492800000",
"number": "1497752893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1406",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600687406",
"telephone_number": "847-568-1870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4711 GOLF RD",
"address_2": "SUITE 808",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761224",
"telephone_number": "847-568-1870",
"fax_number": "847-568-1875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "ALICE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-30",
"last_updated": "2019-10-08",
"deactivation_date": "2006-03-17",
"reactivation_date": "2006-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "IL",
"license": "0036-086420",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA ID",
"identifier": "14D0937849",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036086420",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHEILD",
"identifier": "1621458",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.