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NPI Code Detail

MEDICARE: DUC THINH PHAM M.D.

MEDICARE: DUC THINH PHAM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician036114257IL

General Provider Information

NPI Number : 1326054669
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUC THINH PHAM M.D.
Provider Business Mailing Address
First Line : 680 N LAKE SHORE DR
Second Line : SUITE#1000
City : CHICAGO
State : IL
Zip : 60611-4546
Country : US
Telephone Number : 312-695-9797
Fax Number :
Provider Business Practice Location Address
First Line : 675 N. ST.CLAIR ST
Second Line : 19-100
City : CHICAGO
State : IL
Zip : 60611-5969
Country : US
Telephone Number : 312-664-3278
Fax Number : 312-695-1903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 05/08/2017

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