Provider Demographics
NPI:1154943074
Name:NGUYEN, DIANA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 S WHISPERING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5017
Mailing Address - Country:US
Mailing Address - Phone:847-630-3887
Mailing Address - Fax:
Practice Address - Street 1:151 N STATE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3601
Practice Address - Country:US
Practice Address - Phone:312-863-4249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL049.238327183700000X
IL049238327390200000X
IL051306756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No183700000XPharmacy Service ProvidersPharmacy Technician
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program