Individual provider Active NPI

Phuong Nhu Thi Pham, PA-C

  • Physician Assistant
  • Chicago Ridge, IL
National Provider Identifier
1588454516
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085011147 Issued in IL
Practice address
10258 Southwest Hwy Ste a
Chicago Ridge, IL 60415-1361
Phone
(708) 346-9533
NPI assigned
May 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085011147 IL Primary

Addresses

Primary practice location

10258 Southwest Hwy Ste a
Chicago Ridge, IL 60415-1361

Mailing address

10258 Southwest Hwy Ste a
Chicago Ridge, IL 60415-1361
Phone (708) 346-9533

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801000561 IL Practitioner - Physician Assistant 5395253371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Surgery Associates PLLCGroup PAC ID 0345678132, 7 clinicians

Practice addresses (Care Compare)

10258 Southwest Hwy
Suite a
Chicago Ridge, IL 60415-1361
Phone (708) 346-9533

1890 Silver Cross Blvd
Suite 375
New Lenox, IL 60451-9528
Phone (708) 346-9533

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085011147ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic & Vascular Surgical Associates S C CurrentSince May 18, 2025 Accepting new patients

Locations

10258 Southwest Hwy
Ste A
Chicago Ridge, IL 60415
Phone (708) 346-9533

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1588454516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10258 SOUTHWEST HWY STE A",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151361",
            "telephone_number": "708-346-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10258 SOUTHWEST HWY STE A",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151361",
            "telephone_number": "708-346-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PHUONG",
        "middle_name": "NHU THI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

Verify at the official NPI Registry.