Individual provider Active NPI

Han Ngoc Nguyen

  • Behavior Analyst
  • Worth, IL
National Provider Identifier
1790336378
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-60877 Issued in NU
Practice address
11301 S Harlem Ave
Worth, IL 60482-2001
Phone
(866) 273-8060
NPI assigned
Sep 24, 2019
Last updated
Sep 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Behavior Analyst 103K00000X 1-22-60877 NU Primary

Addresses

Primary practice location

11301 S Harlem Ave
Worth, IL 60482-2001

Mailing address

111 N County Farm Rd
Wheaton, IL 60187-3977

Other practice location 1

115 N County Farm Rd
Wheaton, IL 60187-3977
Phone (630) 627-1700

Other practice location 2

1S273 Ingersoll Lane
Villa Park, IL 60181-6018
Phone (630) 398-1716

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

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1790336378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N COUNTY FARM RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 S HARLEM AVE",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604822001",
            "telephone_number": "866-273-8060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 N County Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601873977",
            "country_code": "US",
            "telephone_number": "630-627-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1S273 Ingersoll Lane",
            "address_purpose": "LOCATION",
            "city": "Villa Park",
            "state": "IL",
            "postal_code": "601816018",
            "country_code": "US",
            "telephone_number": "630-398-1716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HAN",
        "middle_name": "NGOC",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-22-60877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worth, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.