Individual provider · Type 1 NPI

Khaunsavan Vongphakdy, PA

Surgical Physician Assistant · Evanston, IL

NPI number 1609624006 Active

Practice location

2650 Ridge Ave
Evanston, IL 60201-1781

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant Primary 363AS0400X085010441 (IL)

Surgical Physician Assistant: Definition to come...

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About NPI 1609624006

Khaunsavan Vongphakdy, PA's National Provider Identifier is 1609624006, issued on May 9, 2024. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Evanston, IL. The record was last updated on May 13, 2024.