Individual
JUSTINA PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
70 E LAKE ST STE 630, CHICAGO, IL 60601-5961
(312) 298-9577
Mailing address
2146 N DAYTON ST APT 304, CHICAGO, IL 60614-4343
(773) 969-0452
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198001509
IL
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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