Healthcare Provider Details

I. General information

NPI: 1487510491
Provider Name (Legal Business Name): DR. CHRISTOPHER M NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 N WAYNE AVE
CHICAGO IL
60660-1949
US

IV. Provider business mailing address

6220 N WAYNE AVE APT G
CHICAGO IL
60660-1949
US

V. Phone/Fax

Practice location:
  • Phone: 314-498-9285
  • Fax:
Mailing address:
  • Phone: 314-498-9285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.014399
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: