Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036115094 | IL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036115094 | IL |
NPI | 1285880757 |
---|---|
Provider Name | Dr. Thythy T Pham |
First Address | Chicago, IL 60631-3716 |
Second Address | Chicago, IL 60631-3716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2008 |
Last Update Date | 28/04/2021 |