MEDICARE: DR. NINH XUAN TRAN MD

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	208D00000X	General Practice Physician	036061453	IL
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	036061453	IL
3	207Q00000X	Family Medicine Physician	036-061-453	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31601581	OTHER	IL	BCBS OF IL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578659447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NINH XUAN TRAN MD

Provider Business Mailing Address
First Line	:	4947 N WINTHROP AVE
Second Line	:	ARGYLE WINTHROP MEDICAL CENTER
City	:	CHICAGO
State	:	IL
Zip	:	60640-3607
Country	:	US
Telephone Number	:	773-935-9969
Fax Number	:	773-989-9180

Provider Business Practice Location Address
First Line	:	4947 N WINTHROP AVE
Second Line	:	ARGYLE WINTHROP MEDICAL CENTER
City	:	CHICAGO
State	:	IL
Zip	:	60640-3607
Country	:	US
Telephone Number	:	773-935-9969
Fax Number	:	773-989-9180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	09/12/2016

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