Organization
CENTER FOR VEIN RESTORATION IL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHANH Q. NGUYEN DO (OWNER)
(855) 830-8346
Entity
Organization
Contact information
Practice address
2001 BUTTERFIELD RD STE 1000, DOWNERS GROVE, IL 60515-5476
(855) 830-8346
Mailing address
7474 GREENWAY CENTER DR STE 1000, GREENBELT, MD 20770-3500
(152) 541-7618
(815) 254-5431
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036139055
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
06/05/2018
Last updated
04/30/2024
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