Healthcare Provider Details

I. General information

NPI: 1487185583
Provider Name (Legal Business Name): JOSEPHINE BA NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 E BRUSH HILL RD STE 308
ELMHURST IL
60126-5662
US

IV. Provider business mailing address

2650 RIDGE AVE # 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-9006
  • Fax: 331-221-2734
Mailing address:
  • Phone: 847-982-3175
  • Fax: 847-982-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036178663
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA157172
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number036178663
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: