MEDICARE: CATHY NGUYEN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	277.004817	IL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G183022	IA

General Provider Information

NPI Number	:	1740878925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY NGUYEN

Provider Business Mailing Address
First Line	:	1130 S CANAL ST STE 1104
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-5058
Country	:	US
Telephone Number	:	872-255-8540
Fax Number	:	773-302-8676

Provider Business Practice Location Address
First Line	:	1130 S CANAL ST STE 1104
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-5058
Country	:	US
Telephone Number	:	872-255-8540
Fax Number	:

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

Provider Enumeration Date	:	01/04/2021
Last Update Date	:	05/28/2026

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Directions to “ CATHY NGUYEN ” Practice Location

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