Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelley Thuy-Ly Phan

Individual provider Clinical Psychologist · NPI 1114433463

Kelley Thuy-Ly Phan is a Clinical Psychologist in Chicago, Illinois. Qualified in 2020, 6 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California and Illinois.

Years since qualifying
6
Licensed in
CA, IL
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone: (312) 695-6868
Fax: (312) 695-2729
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1650 Moon Lake Blvd, Hoffman Estates, IL 60169-1010 — (714) 404-0383

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071010616 (IL)
Clinical Psychologist Taxonomy 103TC0700X · Licence 071010616 (CA)

Record details

NPI number1114433463
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 22, 2017
Last updated in NPPESNovember 14, 2022
Certification dateNovember 14, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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