Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 036.149610 | IL |
Y | 207ND0900X | Dermatopathologist | 036.149610 | IL |
NPI | 1669817128 |
---|---|
Provider Name | Cuong V Nguyen |
First Address | Chicago, IL 60611-2997 |
Second Address | Chicago, IL 60611-2997 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2013 |
Last Update Date | 20/08/2019 |