MEDICARE: LYNN M PUTOREK-MARLOWE 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	51289010	IL
2	183500000X	Pharmacist	26023014A	IN

General Provider Information

NPI Number	:	1023391802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN M PUTOREK-MARLOWE PHARMD

Provider Business Mailing Address
First Line	:	3611 E 106TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-6610
Country	:	US
Telephone Number	:	773-978-1988
Fax Number	:	773-978-4325

Provider Business Practice Location Address
First Line	:	3611 E 106TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-6610
Country	:	US
Telephone Number	:	773-978-1988
Fax Number	:	773-978-4325

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

Provider Enumeration Date	:	09/27/2011
Last Update Date	:	09/27/2011

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