Healthcare Provider Details

I. General information

NPI: 1407841372
Provider Name (Legal Business Name): QUYNH GIAO NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E LAKE ST STE 1300
CHICAGO IL
60601-7458
US

IV. Provider business mailing address

816 W GEORGE ST
CHICAGO IL
60657-5114
US

V. Phone/Fax

Practice location:
  • Phone: 312-726-4011
  • Fax: 312-726-4021
Mailing address:
  • Phone: 917-531-6853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36117246
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: