Individual
MS. ELLEN DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 N MICHIGAN AVE STE 531, CHICAGO, IL 60601-7426
(773) 240-8414
Mailing address
1420 W CARMEN AVE APT 1, CHICAGO, IL 60640-6800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.016105
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178.016105
—
IL
Enumeration date
08/05/2020
Last updated
08/05/2020
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