NPIMap

Organization Active NPI

Alan Chen Surgical Associates, PC

  • Plastic Surgery Physician
  • Joliet, IL
National Provider Identifier
1881906535
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
036117307 Issued in IL
Legal business name
ALAN CHEN SURGICAL ASSOCIATES, PC
Practice address
823 N 129TH Infantry Dr
Ste 103
Joliet, IL 60435-8346
Phone
(815) 729-9527
Fax
(815) 729-9530
NPI assigned
Jul 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Authorized official

Name
Mr. Henry Clay Gordon Jr.
Title
Biller
Phone
(815) 729-9527

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X 036117307 IL Primary
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X 036117307 IL

Addresses

Primary practice location

823 N 129TH Infantry Dr
Ste 103
Joliet, IL 60435-8346

Mailing address

823 N 129TH Infantry Dr
Ste 103
Joliet, IL 60435-8346
Phone (815) 729-9527

Other identifiers 1

IdentifierTypeStateIssuer
1689878480MedicaidIL

Other names 1

  • Alan Chen Surgical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101005000683 IL Part B Supplier - Clinic/Group Practice 7012109317 Receives reassigned benefits from 3 practitioners
Practice locations: Joliet, IL; Palos Heights, IL

National Provider Directory

National Provider Directory

Locations

11824 Southwest Hwy
Palos Heights, IL 60463
Phone (708) 361-0220

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651622400000",
    "number": "1881906535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 N 129TH INFANTRY DR",
            "address_2": "STE 103",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358346",
            "telephone_number": "815-729-9527",
            "fax_number": "815-729-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 N 129TH INFANTRY DR",
            "address_2": "STE 103",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358346",
            "telephone_number": "815-729-9527",
            "fax_number": "815-729-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN CHEN SURGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-10",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "815-729-9527",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036117307",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036117307",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689878480",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alan Chen Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.