Phan, Binh An Phuong

Phan, Binh An Phuong is an individual health care provider with primary practice located at 2160 S 1St Ave Bldg 110 Rm 6221, Maywood IL 60153-3328. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Phan, Binh An Phuong can be contacted via phone (708) 327-2784.

Contact Information

Primary practice address
2160 S 1St Ave Bldg 110 Rm 6221 Maywood IL 60153-3328
Phone: (708) 327-2784
Fax: (708) 327-2771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036121748 Illinois

Profile Details

NPI number 1457391039
LBN Legal business name Phan, Binh An Phuong
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Sep 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457391039 NPPES
Washington Other 0198831 LIWA
Washington MEDICAID 8431439 LIWA
Washington Other BSWA LIWA

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