Provider Demographics
NPI:1245549369
Name:HOANG-TRAN, TRANGDAI VUONG (O,D)
Entity type:Individual
Prefix:DR
First Name:TRANGDAI
Middle Name:VUONG
Last Name:HOANG-TRAN
Suffix:
Gender:F
Credentials:O,D
Other - Prefix:DR
Other - First Name:TRANGDAI
Other - Middle Name:VUONG
Other - Last Name:HOANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:7018-20 N WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-1413
Mailing Address - Country:US
Mailing Address - Phone:773-274-1880
Mailing Address - Fax:773-274-1881
Practice Address - Street 1:7018-20 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-3416
Practice Address - Country:US
Practice Address - Phone:773-895-4799
Practice Address - Fax:847-384-1860
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010397152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist