MEDICARE: DR. TASHA LENETTE WILLIAMS 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	051-289413	IL

General Provider Information

NPI Number	:	1063681658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TASHA LENETTE WILLIAMS PHARMD

Provider Business Mailing Address
First Line	:	7115 W. NORTH AVENUE
Second Line	:	#200
City	:	OAK PARK
State	:	IL
Zip	:	60302
Country	:	US
Telephone Number	:	773-491-8444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1468 ELMHURST RD
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-6417
Country	:	US
Telephone Number	:	773-491-8444
Fax Number	:

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

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	04/27/2011

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