Provider Demographics
NPI:1578659447
Name:TRAN, NINH XUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NINH
Middle Name:XUAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4947 N WINTHROP AVE
Mailing Address - Street 2:ARGYLE WINTHROP MEDICAL CENTER
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3607
Mailing Address - Country:US
Mailing Address - Phone:773-935-9969
Mailing Address - Fax:773-989-9180
Practice Address - Street 1:4947 N WINTHROP AVE
Practice Address - Street 2:ARGYLE WINTHROP MEDICAL CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3607
Practice Address - Country:US
Practice Address - Phone:773-935-9969
Practice Address - Fax:773-989-9180
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036061453208D00000X, 207RG0300X
IL036-061-453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31601581OtherBCBS OF IL
IL036061453Medicaid
D15902Medicare UPIN
IL036061453Medicaid