Van D Pham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008916 Issued in IL

Practice address

525 Howard St
FL 1
Evanston, IL 60202-4005

Phone

(847) 859-6365

Fax

(847) 859-6385

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1275570913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HOWARD ST",
            "address_2": "FL 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024005",
            "telephone_number": "847-859-6365",
            "fax_number": "847-859-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HOWARD ST",
            "address_2": "FL 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024005",
            "telephone_number": "847-859-6365",
            "fax_number": "847-859-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008916",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "1626166",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Michael Pfeiffer, O.D.
• Kristina Violet Pfeiffer, MD
• Hai Pham, APN-CRNA
• Hillary Pham, PT, DPT
• Ngan Tran Khanh Pham, MD
• Philip H Sheridan Jr SC
• KJ Philip, MD
• Jessica Philipp, CCC-SLP
• Jenny K Philipson, LCSW
• Daniel K. Phillip, PSY.D.

• Optometrist in Evanston, IL
• Providers in Evanston, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.