MEDICARE: VAN A. NGUYEN, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1336247881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAN A. NGUYEN, LTD

Provider Business Mailing Address
First Line	:	2005 BLOOMINGDALE RD
Second Line	:	UNIT C
City	:	GLENDALE HTS
State	:	IL
Zip	:	60139-2151
Country	:	US
Telephone Number	:	630-893-1260
Fax Number	:	630-893-1261

Provider Business Practice Location Address
First Line	:	2005 BLOOMINGDALE RD
Second Line	:	UNIT C
City	:	GLENDALE HTS
State	:	IL
Zip	:	60139-2151
Country	:	US
Telephone Number	:	630-893-1260
Fax Number	:	630-893-1261

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VAN A NGUYEN
Credential	:	D.C.
Telephone Number	:	630-893-1260

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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