Healthcare Provider Details

I. General information

NPI: 1184326829
Provider Name (Legal Business Name): DUNG VAN NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 GOLF RD STE 302
DES PLAINES IL
60016-7900
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-296-8151
  • Fax: 847-674-3358
Mailing address:
  • Phone: 847-296-8151
  • Fax: 847-674-3358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036181010
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: