# THAO NGUYEN TRAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891761524
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 036099127 | IL | — |
| 207W00000X | Ophthalmology Physician | 44790-20 | WI | Yes |

## Other

- **Enumeration date:** 02/23/2006
- **Last updated:** 06/19/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 036099127 | ILLINOIS LICENSE | IL |
| 01 | — | 11357585 | CAQH | — |
| 05 | — | 34243100 | — | WI |
| 01 | — | 44790-20 | WISCONSIN LICENSE | WI |
| 01 | — | F400110685 | MEDICARE PTAN | IL |
| 01 | — | K400133004 | MEDICARE PTAN | WI |