Provider Demographics
NPI:1033630538
Name:HUYNH, QUOC A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:QUOC
Middle Name:A
Last Name:HUYNH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MICKEY
Other - Middle Name:
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3320 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2514
Mailing Address - Country:US
Mailing Address - Phone:773-252-8346
Mailing Address - Fax:
Practice Address - Street 1:3320 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2514
Practice Address - Country:US
Practice Address - Phone:773-252-8346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.300893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist