Vuong, Kelly

Vuong, Kelly is an individual health care provider with primary practice located at 885 Roosevelt Rd Ste 201 , Glen Ellyn IL 60137-6141. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Vuong, Kelly can be contacted via phone (630) 545-3760.

Contact Information

Primary practice address
885 Roosevelt Rd Ste 201 Glen Ellyn IL 60137-6141
Phone: (630) 545-3760
Fax: (630) 545-3769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036110420 Illinois

Profile Details

NPI number 1073511135
LBN Legal business name Vuong, Kelly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Oct 7th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073511135 NPPES
Illinois Other 206147 MEDICARE PTAN (GROUP)
Illinois MEDICAID 036110420 MEDICARE PTAN (GROUP)
Illinois Other P01053223 MEDICARE PTAN (GROUP)
Illinois Other CA4748 MEDICARE PTAN (GROUP)
Illinois Other 206147101 MEDICARE PTAN (GROUP)

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