KHAUNSAVAN VONGPHAKDY

EVANSTON, IL
NPI1609624006
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: IL  085010441)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2024-05-09
Last Update Date2024-05-13
Business Address
KHAUNSAVAN VONGPHAKDY PA
2650 RIDGE AVE
EVANSTON, IL 60201-1781
Phone number: 847-570-2000
Mailing Address
KHAUNSAVAN VONGPHAKDY PA
2650 RIDGE AVE
EVANSTON, IL 60201-1781
Phone number: 847-570-2000