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NPI Code Detail

MEDICARE: MINH THU NGOC NGUYEN DO

MEDICARE: MINH THU NGOC NGUYEN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
22084N0400XNeurology Physician036173889IL

General Provider Information

NPI Number : 1033790910
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINH THU NGOC NGUYEN DO
Provider Business Mailing Address
First Line : 2160 S 1ST AVE
Second Line :
City : MAYWOOD
State : IL
Zip : 60153-3328
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2160 S 1ST AVE
Second Line :
City : MAYWOOD
State : IL
Zip : 60153-3328
Country : US
Telephone Number : 708-216-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2021
Last Update Date : 12/16/2025

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