Individual provider Active NPI

Anna Nguyen, DO

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1245619667
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036146421 Issued in IL
Practice address
4700 S California Ave
Chicago, IL 60632-2016
Phone
(773) 584-6100
Fax
(773) 869-9321
NPI assigned
May 19, 2015
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-146421 IL
Family Medicine Physician 207Q00000X 036146421 IL Primary

Addresses

Primary practice location

4700 S California Ave
Chicago, IL 60632-2016

Mailing address

4700 S California Ave
Chicago, IL 60632-2016
Phone (773) 584-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808002104 IL Practitioner - Family Practice 7719235639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern Univ College of Dental Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esperanza Health CentersGroup PAC ID 2961453105, 53 clinicians

Practice addresses (Care Compare)

4700 S California Ave
Chicago, IL 60632-2016
Phone (773) 584-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036-146421ILMDFamily Medicine Physician
036146421ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Centers Current Accepting new patients
Erie Family Health Center Inc. CurrentSince Sep 4, 2018 Accepting new patients
Esperanza Health Centers CurrentSince Jul 11, 2022 Accepting new patients
Erie Family Health Center Inc CurrentSince Sep 4, 2018 Accepting new patients
Esperanza Health Centers CurrentSince Jul 11, 2022 Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients

Locations

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-2056

2001 S California Ave
Chicago, IL 60608
Phone (773) 484-1201

2001 S California Ave
Ste 100
Chicago, IL 60608
Phone (773) 640-5785

4700 S California Ave
Chicago, IL 60632
Phone (708) 713-0078

5215 N California Ave
Ste F700
Chicago, IL 60625

Interoperability endpoints

  • Direct secure messaging: anna.nguyen.1@11903.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1245619667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606322016",
            "telephone_number": "773-584-6200",
            "fax_number": "773-869-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606322016",
            "telephone_number": "773-584-6100",
            "fax_number": "773-869-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-146421",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036146421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.