Phan, Michelle Quynh Dao

Phan, Michelle Quynh Dao is an individual health care provider with primary practice located at 845 W Wilson Ave , Chicago IL 60640-8090. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Phan, Michelle Quynh Dao can be contacted via phone (773) 506-4283.

Contact Information

Primary practice address
845 W Wilson Ave Chicago IL 60640-8090
Phone: (773) 506-4283
Fax: (773) 506-4847
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD468228 Pennsylvania
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A163063 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35.136445 Ohio
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036.150664 Illinois

Profile Details

NPI number 1417311374
LBN Legal business name Phan, Michelle Quynh Dao
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2016
Last updated Apr 7th, 2020 - about 6 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 1417311374 NPPES
Illinois MEDICAID 036150664

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