Individual provider Active NPI

Anthony Hoang Nguyen, ATC

  • Athletic Trainer
  • Oak Brook, IL
National Provider Identifier
1295490811
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096004639 Issued in IL
Practice address
2122 York Rd
Oak Brook, IL 60523-1930
Phone
(877) 284-5384
NPI assigned
Nov 8, 2021
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096004639 IL Primary

Addresses

Primary practice location

2122 York Rd
Oak Brook, IL 60523-1930

Mailing address

6430 N Maplewood Ave
Chicago, IL 60645-5316
Phone (312) 459-0091

Other practice location 1

2601 Dempster St
Park Ridge, IL 60068-1155
Phone (847) 825-4484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
096004639ILMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Maine East School Based Health Center Past Accepting new patients
University of Chicago Past Accepting new patients

Organizations & group practices 2

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1295490811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 N MAPLEWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455316",
            "telephone_number": "312-459-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 YORK RD",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231930",
            "telephone_number": "877-284-5384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681155",
            "country_code": "US",
            "telephone_number": "847-825-4484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANTHONY",
        "middle_name": "HOANG",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096004639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.