MICHELLE QUYNH DAO PHAN M.D. NPI 1417311374

NPI Information

NPI: 1417311374
Provider Name: MICHELLE QUYNH DAO PHAN, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
845 W WILSON AVE
CHICAGO, IL
ZIP 60640
Phone: (773) 506-4283
Get Directions

Michelle Quynh Dao Phan, M.D. is a pediatrics in Chicago, IL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Michelle Quynh Dao Phan, M.D. NPI is 1417311374. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

845 W WILSON AVE
CHICAGO, IL
ZIP 60640-090
Phone: (773) 506-4283
Fax: (773) 506-4847

The NPI 1417311374 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 4/7/2016 and was last updated on 4/7/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	208000000X	Pediatrics	036.150664	ILLINOIS	Yes
2	208000000X	Pediatrics	35.136445	OHIO	No
3	208000000X	Pediatrics	A163063	CALIFORNIA	No
4	208000000X	Pediatrics	MD468228	PENNSYLVANIA	No
5	390200000X	Student in an Organized Health Care Education/Training Program			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036150664	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »