MEDICARE: DR. NGA TRAN

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
1	183500000X	Pharmacist	051298798	IL

General Provider Information

NPI Number	:	1841646379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NGA TRAN

Provider Business Mailing Address
First Line	:	2502 WAUKEGAN RD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60025-1774
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2502 WAUKEGAN RD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60025-1774
Country	:	US
Telephone Number	:	847-486-0847
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2016
Last Update Date	:	05/13/2016

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