Healthcare Provider Details

I. General information

NPI: 1952237711
Provider Name (Legal Business Name): AMY LE NGUYEN PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N COLUMBUS DR
CHICAGO IL
60601-7801
US

IV. Provider business mailing address

6114 N ARTESIAN AVE APT 2
CHICAGO IL
60659-2831
US

V. Phone/Fax

Practice location:
  • Phone: 312-861-0315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.308674
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: