Healthcare Provider Details

I. General information

NPI: 1407433220
Provider Name (Legal Business Name): ANDREW TRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 BOND ST
NAPERVILLE IL
60563-2358
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 630-357-7536
  • Fax: 630-904-0413
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036.181572
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: