Provider Demographics
NPI:1144282328
Name:CHEN, KE (MD)
Entity type:Individual
Prefix:
First Name:KE
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5203
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-0203
Mailing Address - Country:US
Mailing Address - Phone:319-855-3396
Mailing Address - Fax:
Practice Address - Street 1:500 E MARKET ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2689
Practice Address - Country:US
Practice Address - Phone:319-339-3600
Practice Address - Fax:319-339-3786
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036120320207P00000X
IA32791207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA8185660Medicaid
IA1144282328OtherBLUE SHIELD
IA1144282328Medicaid
IA40329OtherBLUE CROSS BLUE SHIELD
IA1144282328OtherBLUE SHIELD
IA8185660Medicaid
IA1144282328Medicaid