Individual provider Active NPI

Mai Ngoc Xuan Nguyen, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1659711950
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.131826 Issued in IL
Practice address
3660 N Lake Shore Dr
Unit # 3808
Chicago, IL 60613-5300
Phone
(773) 307-5056
NPI assigned
Jul 1, 2013
Last updated
Jul 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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 036.131826 IL Primary

Addresses

Primary practice location

3660 N Lake Shore Dr
Unit # 3808
Chicago, IL 60613-5300

Mailing address

3660 N Lake Shore Dr
Unit # 3808
Chicago, IL 60613-5300
Phone (773) 307-5056

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
I20130828000882 IL Practitioner - Family PracticePractitioner - Emergency Medicine 5193968824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvey Emergency Physicians PLLCGroup PAC ID 9436486560, 50 clinicians

Practice addresses (Care Compare)

1600 Torrence Ave
Calumet City, IL 60409-5430
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.131826ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvey Emergency Physicians, PLLC CurrentSince Nov 17, 2020 Accepting new patients
Mea Chicago PC CurrentSince Sep 1, 2017 Accepting new patients

Locations

1600 Torrence Ave
Calumet City, IL 60409
Phone (708) 730-1300

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

Interoperability endpoints

  • Direct secure messaging: mnguyenmd237243@uchospital.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1659711950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 N LAKE SHORE DR",
            "address_2": "UNIT # 3808",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135300",
            "telephone_number": "773-307-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 N LAKE SHORE DR",
            "address_2": "UNIT # 3808",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135300",
            "telephone_number": "773-307-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MAI",
        "middle_name": "NGOC XUAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.131826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.