Healthcare Provider Details

I. General information

NPI: 1073457750
Provider Name (Legal Business Name): ALEX HUY DANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 S WOOD ST # MC886
CHICAGO IL
60612-7229
US

IV. Provider business mailing address

833 S WOOD ST # MC886
CHICAGO IL
60612-7229
US

V. Phone/Fax

Practice location:
  • Phone: 312-866-0251
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051307623
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: