Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 036116210 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 2001016936 | MO |
NPI | 1023017019 |
---|---|
Provider Name | Dr. Paul H Nguyen |
First Address | Sycamore, IL 60178-3180 |
Second Address | Sycamore, IL 60178-3180 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 31/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036116210 | (05) | IL |
200308280A | (05) | KS |
207248907 | (05) | MO |
I27099 | (02) | |
I27099 | (02) | IL |