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

Individual provider Physician Assistant · NPI 1609624006

Khaunsavan Vongphakdy, PA is a Physician Assistant in Evanston, Illinois. Qualified in 2023, 3 years ago. Practices with Endeavor Health Medical Group, a 3,348-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2650 Ridge Ave
Evanston, IL 60201-1781
Phone: (847) 570-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 085010441 (IL)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1609624006
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 9, 2024
Last updated in NPPESMay 13, 2024
Certification dateMay 13, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Endeavor Health Medical Group — 3348 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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