JACKSON W CHEN M.D. NPI 1316113954

NPI Information

  • NPI: 1316113954
  • Provider Name: JACKSON W CHEN, M.D.
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • Address: 209 INDIAN TRAIL RD
    OAK BROOK, IL
    ZIP 60523
  • Phone: (760) 717-1412

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NPI Details

Jackson W Chen, M.D. is a general practice in Oak Brook, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Jackson W Chen, M.D. NPI is 1316113954. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

209 INDIAN TRAIL RD
OAK BROOK, IL
ZIP 60523-797
Phone: (760) 717-1412
Fax: (760) 918-0960

The enumeration date for this NPI number is 5/4/2008 and was last updated on 5/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeC50725CALIFORNIANo
2208D00000XGeneral Practice036-047434ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1245-850MEDICARE PINILLINOIS
20021606157OTHERILLINOISBLUE CROSS BLUE SHIELD OF ILLINOIS
3D10209MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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