Justin Jie Chen

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036155255 Issued in IL

Practice address

5215 N California Ave Ste F602
Chicago, IL 60625-8564

Phone

(773) 878-3627

Fax

(773) 878-0985

NPI assigned

May 22, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Family Practice

Education

Arizona College of Osteopathic Medicine Mid Western University, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health Home health agency, Northbrook, IL, CCN 147001
• Swedish Hospital Hospital, Chicago, IL, CCN 140114
• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Swedish Covenant Management Services, Inc.

  dba Swedish Covenant Medical Group

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1760432348

  Family Medicine

  Medicare reassignment NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Swedish Covenant Management Services, Inc

  dba Swedish Emergency Medicine

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1962049551
  NPD

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

• Endeavor Health Clinical Operations

  dba Endeavor Health Evanston Hospital

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Residential Home Health Illinois, LLC

  dba Residential Home Health

  • Home Health Agency
  • Northbrook, IL
  • NPI 1114673787
  Care Compare affiliation
• Swedish Covenant Health

  dba Endeavor Health Swedish Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1962993238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE STE F602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258564",
            "telephone_number": "773-878-3627",
            "fax_number": "773-878-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE STE F602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258564",
            "telephone_number": "773-878-3627",
            "fax_number": "773-878-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JUSTIN",
        "middle_name": "JIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036155255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchen277978@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5215 N California Ave Ste F602",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606258564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeree Rigor Pucan Chen, MD
• Jessie Chen, MS, CGC
• Joell Chen, DMD
• Jordan Chen
• Joseph Chen, PH.D.
• Kevin Chen
• Kevin Chen, NP-C
• Kevin Chen, MD
• Kevin Chen
• Kun Chen, MD

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.