Individual
NGUYEN TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
PA6238
MA
363A00000X
Physician Assistant
Primary
085006687
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA6238
PSYCHIATRY
MA
Enumeration date
08/23/2017
Last updated
04/24/2019
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