Individual
DR. MYTO DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MB, BCH, BAO
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1000
(217) 545-7409
(217) 545-2711
Mailing address
PO BOX 19638, SPRINGFIELD, IL 62794-9638
(217) 545-7409
(217) 545-2711
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-121953
IL
390200000X
Student in an Organized Health Care Education/Training Program
2005018588
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121953
—
IL
Enumeration date
07/02/2007
Last updated
12/20/2021
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