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General NPI Number Information
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NPI Number | 1285880757
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Entity Type | Individual
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Provider Name | THYTHY T PHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT AVE STE 507
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City | CHICAGO
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State | IL
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Zip | 60631-3716
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Country | US
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Telephone | 773-792-8671
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Fax | 773-792-8672
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT AVE STE 507
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City | CHICAGO
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State | IL
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Zip | 60631-3716
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Country | US
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Telephone | 773-792-8671
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Fax | 773-792-8672
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036115094
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 036115094
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License Number State | IL
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