NPIMap

Organization Active NPI

Daniel H Pham, LLC.

  • Optometrist
  • Rockford, IL
National Provider Identifier
1528100880
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
46008703 Issued in IL
Legal business name
DANIEL H PHAM, LLC.
Practice address
3849 Northridge Dr
Rockford, IL 61114-4773
Phone
(815) 636-0440
Fax
(815) 636-0156
NPI assigned
Feb 13, 2007
Last updated
Aug 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Authorized official

Name
Dr. Daniel PhamNPI 1558372524
Title
President
Phone
(312) 848-2181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 46008703 IL Primary

Addresses

Primary practice location

3849 Northridge Dr
Rockford, IL 61114-4773

Mailing address

4284 Valley View Dr
Loves Park, IL 61111-8658

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1528100880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4284 VALLEY VIEW DR",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611118658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3849 NORTHRIDGE DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611144773",
            "telephone_number": "815-636-0440",
            "fax_number": "815-636-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL H PHAM, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-848-2181",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46008703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.