MEDICARE: DR. EDWARD NGUYEN M.D.,PH.D.

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	207VE0102X	Reproductive Endocrinology Physician	036.170188	IL
2	207VG0400X	Gynecology Physician	036.170188	IL

General Provider Information

NPI Number	:	1871974576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD NGUYEN M.D.,PH.D.

Provider Business Mailing Address
First Line	:	900 N KINGSBURY ST STE RW-6
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-7461
Country	:	US
Telephone Number	:	312-222-8230
Fax Number	:	312-467-0743

Provider Business Practice Location Address
First Line	:	200 HAWKINS DR
Second Line	:	DEPT. OF OB/GYN
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1009
Country	:	US
Telephone Number	:	319-356-2294
Fax Number	:	319-356-7533

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

Provider Enumeration Date	:	06/18/2015
Last Update Date	:	04/16/2026

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