Most Relevant Information
Provider Data
| NPI Number: | 1003435868 |
| Provider Name: | JUN PHAN RDN,LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164007244 |
Most Important Dates
| Enumeration Date: | 04/13/2020 |
| Last Updated: | 04/16/2020 |
Provider Practice Location
850 W IRVING PARK RD
CHICAGO
IL
606133077
Practice Location Phone/Fax
| Phone: | 7739756802 |
| Fax: |
Provider Mailing Location
850 W IRVING PARK RD
CHICAGO
IL
606133077
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |