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NPI Code Detail

MEDICARE: THINH NGUYEN

MEDICARE: THINH NGUYEN
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
1183500000XPharmacist051288709IL

General Provider Information

NPI Number : 1467733246
Entity Type Code : Individual
Provider Name (Legal Business Name) : THINH NGUYEN
Provider Business Mailing Address
First Line : 6101 N LAWNDALE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3113
Country : US
Telephone Number : 773-539-0842
Fax Number :
Provider Business Practice Location Address
First Line : 3019 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3726
Country : US
Telephone Number : 773-728-6254
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2011
Last Update Date : 09/07/2011

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Directions to “ THINH NGUYEN ” Practice Location

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