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Individual

ANTHONY PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 S FAIRFIELD AVE, CHICAGO, IL 60608-1782
(773) 257-5914
Mailing address
646 S RUE MARCEL, GRETNA, LA 70056-8203
(504) 289-5784

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125.079423
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/19/2022
Last updated
04/11/2023
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