Individual
DR. VAN D PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
525 HOWARD ST, FL 1, EVANSTON, IL 60202-4005
(847) 859-6365
(847) 859-6385
Mailing address
525 HOWARD ST, FL 1, EVANSTON, IL 60202-4005
(847) 859-6365
(847) 859-6385
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008916
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008916
—
IL
01
—
1626166
BCBSIL
IL
Enumeration date
06/01/2006
Last updated
10/03/2018
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