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NPI Code Detail

MEDICARE: SOLOMON TAM PHARM D

MEDICARE:   SOLOMON  TAM  PHARM D
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
1183500000XPharmacist051.294276IL

General Provider Information

NPI Number : 1043597149
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOLOMON TAM PHARM D
Provider Business Mailing Address
First Line : 3121 S EMERALD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-3012
Country : US
Telephone Number : 312-808-1984
Fax Number :
Provider Business Practice Location Address
First Line : 3405 S KING DR
Second Line :
City : CHICAGO
State : IL
Zip : 60616-4108
Country : US
Telephone Number : 312-326-4058
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2011
Last Update Date : 11/03/2011

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Directions to “ SOLOMON TAM PHARM D” Practice Location

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