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NPI Code Detail

MEDICARE: DENNIS NGUYEN LCSW

MEDICARE: DENNIS NGUYEN LCSW
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
11041C0700XClinical Social Worker149019184IL

General Provider Information

NPI Number : 1740671965
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS NGUYEN LCSW
Provider Business Mailing Address
First Line : 433 W HARRISON ST # 5409
Second Line :
City : CHICAGO
State : IL
Zip : 60699-3916
Country : US
Telephone Number : 224-707-0633
Fax Number :
Provider Business Practice Location Address
First Line : 333 N MICHIGAN AVE STE 704
Second Line :
City : CHICAGO
State : IL
Zip : 60601-3905
Country : US
Telephone Number : 224-707-0633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2015
Last Update Date : 04/26/2018

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