Individual provider Active NPI

Phuong Lien Tran, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1821137142
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-089675 Issued in IL
Practice address
5129 North Broadway Street
Suite E
Chicago, IL 60640-3012
Phone
(773) 275-4250
Fax
(773) 275-4263
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-089675 IL Primary

Addresses

Primary practice location

5129 North Broadway Street
Suite E
Chicago, IL 60640-3012

Mailing address

5129 North Broadway Street
Suite E
Chicago, IL 60640-3012
Phone (773) 275-4250

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
I20101015000486 IL Practitioner - Internal Medicine 0244423812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Connecticut School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5129 N Broadway St
Suite E
Chicago, IL 60640-3012
Phone (773) 275-4250

Hospital & facility affiliations

  • Entera Healthcare South Home health agency, Oak Brook, IL, CCN 147777
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Thorek Memorial Hospital Hospital, Chicago, IL, CCN 140115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-089675ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Village Medical Clinic PC CurrentSince May 1, 2002 Accepting new patients

Locations

5129 N Broadway St
Ste E
Chicago, IL 60640
Phone (773) 275-4250

Interoperability endpoints

  • Direct secure messaging: ptran251670@direct.myadvocateaurora.org

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1821137142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5129 NORTH BROADWAY STREET",
            "address_2": "SUITE E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403012",
            "telephone_number": "773-275-4250",
            "fax_number": "773-275-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5129 NORTH BROADWAY STREET",
            "address_2": "SUITE E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403012",
            "telephone_number": "773-275-4250",
            "fax_number": "773-275-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PHUONG",
        "middle_name": "LIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-089675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.