MEDICARE: MRS. TONYA N PAYTON-CAMPBELL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	051040525	IL

General Provider Information

NPI Number	:	1013294578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TONYA N PAYTON-CAMPBELL PHARMD

Provider Business Mailing Address
First Line	:	2351 E 71ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2537
Country	:	US
Telephone Number	:	773-358-4135
Fax Number	:	773-358-4137

Provider Business Practice Location Address
First Line	:	2351 E 71ST ST STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2537
Country	:	US
Telephone Number	:	773-358-4135
Fax Number	:	773-358-4137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2011
Last Update Date	:	12/23/2022

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