DR. DAVID PHAN (NPI# 1972099307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972099307 |
| Entity Type | Individual |
| Full Name | DR. DAVID PHAN |
| Credential | OD |
| Practice Address |
1753 E 95th St Ste B-100 Chicago IL 60617 |
| Mailing Address |
4840 N Sheridan Rd Apt 1 Chicago IL 60640-4048 |
| Practice Telephone | 7733644938 |
| Mailing Telephone | 3123307005 |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046.011205 | IL | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11750 S Marshfield Ave, Chicago, IL 606434904 | 7735683479 | |
| 1400 W 47th St, Chicago, IL 606093232 | 7736405384 | |
| 205 W 87th St Ste D, Chicago, IL 606201321 | 7734965433 | |
| 4741 W Cermak Rd, Cicero, IL 608042508 | 7083911763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578028353 | David Minh Phan | Pharmacist | 4126 Lake Placid Ct, Antelope, CA 95843-5267 | 2019-02-05 |
| 1295098846 | David Phan | Dentist | 10747 Collett Ave, Riverside, CA 92505-2923 | 2012-06-19 |
| 1033187190 | David Coang Phan | Chiropractor | 18575 Gale Ave, City of Industry, CA 91748-1340 | 2006-03-14 |
| 1619530359 | David Vinh Phan | Behavior Technician | 17595 Almahurst St, City of Industry, CA 91748-1779 | 2019-04-18 |
| 1316217227 | David Phan | Pharmacist | 6565 Fannin St, Houston, TX 77030-2703 | 2012-01-09 |
| 1578831897 | David Phan | Pharmacist | 1600 W Roosevelt Rd, Broadview, IL 60155-4024 | 2011-12-01 |
| Street Address |
1753 E 95TH ST STE B-100 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| 1821545476 | Martin Acevedo | Social Worker | 3062 E 91st Street, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392587 | Adriana Casillas | Optometrist | 11129 S Avenue J, Chicago, IL 60617-6910 | 2020-09-25 |
| 1538778097 | Opt Vision | Optometrist | 5371 W Lawrence Ave Ste A, Chicago, IL 60630-3695 | 2020-07-30 |
| 1578180147 | Ortizii PC | Optometrist | 111 N Wabash Ave Ste 1111, Chicago, IL 60602-3119 | 2020-06-30 |
| 1588280358 | Iwona B. Lazarz | Optometrist | 6500 W Irving Park Rd Ste I, Chicago, IL 60634-2454 | 2020-06-17 |
| 1134741622 | Cvs Aoc Services, L.L.C. | Optometrist | 4051 North Lincoln, Store 8751, Chicago, IL 60618 | 2020-05-07 |
| 1154941367 | Sun Myung Park | Optometrist | 465 N Park Dr Apt 2203, Chicago, IL 60611-0008 | 2020-04-17 |
| 1578196341 | Steven K. Siu | Optometrist | 2719 S Princeton Ave Fl 1, Chicago, IL 60616-4883 | 2020-02-19 |
| 1235789884 | Courtney Bandemer | Optometrist | 3708 N Southport Ave, Chicago, IL 60613-6888 | 2019-09-16 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1154977759 | Keralyn Totten | Optometrist | 230 E Ohio St Ste 120, Chicago, IL 60611-3266 | 2019-08-11 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.