Provider Demographics
NPI:1427589357
Name:NGUYEN, HOA THI
Entity Type:Individual
Prefix:
First Name:HOA
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOANG HOA
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 950
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2955
Mailing Address - Country:US
Mailing Address - Phone:312-694-7337
Mailing Address - Fax:312-695-0156
Practice Address - Street 1:676 N SAINT CLAIR ST STE 950
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2955
Practice Address - Country:US
Practice Address - Phone:312-694-7337
Practice Address - Fax:312-695-0156
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.157094207VF0040X
IL036157094207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program