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General NPI Number Information
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NPI Number | 1205446127
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Entity Type | Individual
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Provider Name | MS. ELLEN DUONG
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Gender | Female
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 180 N MICHIGAN AVE STE 531
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City | CHICAGO
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State | IL
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Zip | 60601-7426
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Country | US
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Telephone | 773-240-8414
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 W CARMEN AVE APT 1
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City | CHICAGO
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State | IL
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Zip | 60640-6800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178.016105
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License Number State | IL
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