Individual provider Active NPI

Elizabeth M.P. Nguyen, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1568699346
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036130697 Issued in IL
Practice address
2424 W Peterson Ave
Chicago, IL 60659-4100
Phone
(773) 761-0300
Fax
(773) 761-0009
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036130697 IL Primary

Addresses

Primary practice location

2424 W Peterson Ave
Chicago, IL 60659-4100

Mailing address

2424 W Peterson Ave
Chicago, IL 60659-4100
Phone (773) 761-0300

Other identifiers 1

IdentifierTypeStateIssuer
036130697MedicaidIL

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
I20120821000848 IL Practitioner - Family Practice 5294982591 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036130697ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Human Services Family Health Center, Inc CurrentSince Dec 1, 2022 Accepting new patients
Asian Human Services Family Health Center, Inc. Current Accepting new patients
Asian Human Services Family Health Center CurrentSince Dec 1, 2022 Accepting new patients

Locations

2501 W Peterson Ave
Chicago, IL 60659
Phone (773) 761-0300

2424 W Peterson Ave
Chicago, IL 60659
Phone (773) 761-0300

8800 Lockwood Ave
Skokie, IL 60077
Phone (773) 761-0300

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1568699346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594100",
            "telephone_number": "773-761-0300",
            "fax_number": "773-761-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594100",
            "telephone_number": "773-761-0300",
            "fax_number": "773-761-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ELIZABETH",
        "middle_name": "M.P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036130697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036130697",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.