Individual
PAULINE PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 355-1222
Mailing address
855 W MADISON ST APT 912, CHICAGO, IL 60607-3138
(408) 829-5490
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
018.002298
IL
390200000X
Student in an Organized Health Care Education/Training Program
018.002298
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018.002298
IDFPR
IL
Enumeration date
04/03/2019
Last updated
07/17/2025
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