Provider Demographics
NPI:1285880757
Name:PHAM, THYTHY T (MD)
Entity type:Individual
Prefix:DR
First Name:THYTHY
Middle Name:T
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:7447 W TALCOTT AVE STE 507
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3716
Mailing Address - Country:US
Mailing Address - Phone:773-792-8671
Mailing Address - Fax:773-792-8672
Practice Address - Street 1:7447 W TALCOTT AVE STE 507
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3716
Practice Address - Country:US
Practice Address - Phone:773-792-8671
Practice Address - Fax:773-792-8672
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115094207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology